{"reporting_entity_name":"Healthfirst Insurance Company","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-06-24","version":"2.0.0","provider_references":[{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003861725],"tin":{"type":"npi","value":"1003861725"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003378845],"tin":{"type":"npi","value":"1003378845"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003575085],"tin":{"type":"npi","value":"1003575085"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184935264],"tin":{"type":"npi","value":"1184935264"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1487790259],"tin":{"type":"npi","value":"1487790259"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003042672],"tin":{"type":"npi","value":"1003042672"}}]}],"in_network":[{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62160","name":"Neuroendoscopy add-on","description":"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66130","name":"Remove eye lesion","description":"Excision of lesion, sclera","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43200","name":"Esophagoscopy flexible brush","description":"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38212","name":"Rbc depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; red blood cell removal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17270","name":"Dstr mal les s/n/h/f/g .5 /<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27443","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63300","name":"Remove vert xdrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1459.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25600","name":"Cltx dst rdl fx/ephys sep wo","description":"Closed treatment of distal radial fracture (eg, colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28450","name":"Tx tarsal b1 fx w/o mnpj ea","description":"Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87850","name":"N. gonorrhoeae assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; neisseria gonorrhoeae","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61563","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35476","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85390","name":"Fibrinolysins screen i&r","description":"Fibrinolysins or coagulopathy screen, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0244","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4108.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50976","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62272","name":"Ther spi pnxr drg csf","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25335","name":"Centralization wrist on ulna","description":"Centralization of wrist on ulna (eg, radial club hand)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36660","name":"Insertion catheter artery","description":"Catheterization, umbilical artery, newborn, for diagnosis or therapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62320","name":"Njx interlaminar crv/thrc","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43887","name":"Gstr rstcv px opn rmvl port","description":"Gastric restrictive procedure, open; removal of subcutaneous port component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97163","name":"Pt eval high complex 45 min","description":"Physical therapy evaluation: high complexity, requiring these components: a history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures addressing a total of 4 or more elements from","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3000.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50690","name":"Injection for ureter x-ray","description":"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40842","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43123","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4023.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52648","name":"Laser surgery of prostate","description":"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91117","name":"Colon motility 6 hr study","description":"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0238","name":"Oth resp proc, indiv","description":"Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29035","name":"Appl body cast sho to hips","description":"Application of body cast, shoulder to hips;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83704","name":"Lipoprotein bld quan part","description":"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31296","name":"Nsl/sins ndsc surg frnt sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0560T","name":"Antmc mdl 3d print ea addl","description":"Anatomic model 3d-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99186","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47511","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63272","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43242","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15834","name":"Exc excessive skin hip","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37233","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0083","name":"Care man h v ext pt 45 m","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54324","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22901","name":"Exc abdl tum deep 5 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0430","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9985","name":"Remote e/m est. pt 25mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history;  a detailed exam","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86406","name":"Particle agglut antbdy titr","description":"Particle agglutination; titer, each antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58410","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2572.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93597","name":"R&l hrt cath chd abnl nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86886","name":"Coombs test indirect titer","description":"Antihuman globulin test (coombs test); indirect, each antibody titer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36838","name":"Dist revas ligation hemo","description":"Distal revascularization and interval ligation (dril), upper extremity hemodialysis access (steal syndrome)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88165","name":"Cytopath tbs c/v redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and rescreening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81184","name":"Cacna1a gen detc abnor allel","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50693","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90867","name":"Tcranial magn stim tx plan","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43204","name":"Esoph scope w/sclerosis inj","description":"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78593","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55550","name":"Laparo ligate spermatic vein","description":"Laparoscopy, surgical, with ligation of spermatic veins for varicocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33775","name":"Rpr tga atr bfl rmvl plm bnd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with removal of pulmonary band","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53447","name":"Remove/replace ur sphincter","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15750","name":"Neurovascular pedicle flap","description":"Flap; neurovascular pedicle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23670","name":"Optx sho dislc fx","description":"Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11102","name":"Tangntl bx skin single les","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22858","name":"Tot disc arthrp 2nd lvl crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1893","name":"Intro/sheath, fixed,non-peel","description":"Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98940","name":"Chiropract manj 1-2 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 1-2 regions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22336.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["BA","95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24345","name":"Repr elbw med ligmnt w/tissu","description":"Repair medial collateral ligament, elbow, with local tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67973","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97140","name":"Manual therapy 1/> regions","description":"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4261","name":"Cervical cap contraceptive","description":"Cervical cap for contraceptive use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21820","name":"Treat sternum fracture","description":"Closed treatment of sternum fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0412","name":"Open tx iliac spine uni/bil","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31577","name":"Largsc w/rmvl foreign bdy(s)","description":"Laryngoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29906","name":"Subtalar arthro w/deb","description":"Arthroscopy, subtalar joint, surgical; with debridement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37213","name":"Thromblytic art/ven therapy","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83499","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64627","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21632","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8053.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95980","name":"Io anal gast n-stim init","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50961","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11646","name":"Exc f/e/e/n/l mal+mrg >4 cm","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99453","name":"Rem mntr physiol param setup","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0576T","name":"Interrog dev eval icds ss ip","description":"Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75558","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90476","name":"Adenovirus vaccine type 4","description":"Adenovirus vaccine, type 4, live, for oral use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42210","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44406","name":"Colonoscopy w/ultrasound","description":"Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61020","name":"Remove brain cavity fluid","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0070","name":"Transport portable x-ray","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43831","name":"Gastrostomy open neonatal","description":"Gastrostomy, open; neonatal, for feeding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0393","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64872","name":"Subsequent repair of nerve","description":"Suture of nerve; requiring secondary or delayed suture (list separately in addition to code for primary neurorrhaphy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25251","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; complicated, including total wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59050","name":"Fetal monitor w/report","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86490","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55801","name":"Removal of prostate","description":"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21184","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2249.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26117","name":"Rad resect hand tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37214","name":"Cessj therapy cath removal","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4220","name":"Infusion pump refill kit","description":"Refill kit for implantable infusion pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4161","name":"Ef ped hydrolyzed/amino acid","description":"Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66990","name":"Ophthalmic endoscope add-on","description":"Use of ophthalmic endoscope (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25515","name":"Optx radial shaft fracture","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17311","name":"Mohs 1 stage h/n/hf/g","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), h","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87451","name":"Polyvalent mult org ea ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26372","name":"Repair/graft hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63266","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93596","name":"R&l hrt cath chd nml nt cnj","description":"Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24577","name":"Cltx humrl cndylr fx w/mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21344","name":"Open tx compl front sinus fx","description":"Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45020","name":"Drainage of rectal abscess","description":"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358T","name":"Bia whole body","description":"Bioelectrical impedance analysis whole body composition assessment, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89330","name":"Evaluation cervical mucus","description":"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23600","name":"Cltx prox humrl fx w/o mnpj","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12007","name":"Rpr s/n/ax/gen/trnk >30.0 cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33369","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95990","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77418","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37187","name":"Venous mech thrombectomy","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21601","name":"Exc chest wall tumor w/ribs","description":"Excision of chest wall tumor including rib(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63663","name":"Revise spine eltrd perq aray","description":"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47711","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2995.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94360","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39401","name":"Mediastinoscpy w/medstnl bx","description":"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9275","name":"Disp home glucose monitor","description":"Home glucose disposable monitor, includes test strips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54410","name":"Remove/replace penis prosth","description":"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83894","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46260","name":"Remove in/ex hem groups 2+","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58573","name":"Tlh w/t/o uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96571","name":"Photodynamic tx addl 15 min","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33851","name":"Exc coa rpr l subcl art/prst","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material as gusset for enlargement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28735","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29825","name":"Sho arthrs srg lss&rescj ads","description":"Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22586","name":"Arthrd pre-sac ntrbdy l5-s1","description":"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95024","name":"Iq tests w/allergenic xtrcs","description":"Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35246","name":"Rpr blvsl vn grf ntrthrc w/o","description":"Repair blood vessel with vein graft; intrathoracic, without bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33889","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71040","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63043","name":"Laminotomy addl cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional cervical interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3350.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95723","name":"Eeg phy/qhp>60<84 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of eeg recording, without video","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50555","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33741","name":"Tas congenital car anomal","description":"Transcatheter atrial septostomy (tas) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, rashkind, sang-park, balloon, cutting balloon, blade)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27722","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with sliding graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40761","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (abbe-estlander type), including sectioning and inserting of pedicle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22220","name":"Osteot dsc ant 1 vrt sgm crv","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"C2617","name":"Stent, non-cor, tem w/o del","description":"Stent, non-coronary, temporary, without delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15820","name":"Blepharoplasty lower eyelid","description":"Blepharoplasty, lower eyelid;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84445","name":"Assay of tsi globulin","description":"Thyroid stimulating immune globulins (tsi)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95852","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5706.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87252","name":"Virus inoculation tissue","description":"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0218T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35276","name":"Rpr blvs gr ot/t vn ntrth wo","description":"Repair blood vessel with graft other than vein; intrathoracic, without bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95833","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21510","name":"Inc deep opng b1 crtx thorax","description":"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47420","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1769","name":"Guide wire","description":"Guide wire","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","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":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9645.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22526","name":"Idet single level","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17284","name":"Dstr mal ls f/e/e/n/l/m3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63700","name":"Repair of spinal herniation","description":"Repair of meningocele; less than 5 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1184.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23515","name":"Optx clavicular fx w/int fix","description":"Open treatment of clavicular fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93797","name":"Phys/qhp op car rhab wo ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ecg monitoring (per session)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19303","name":"Mast simple complete","description":"Mastectomy, simple, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36561","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0047","name":"Alcohol/drug abuse svc nos","description":"Alcohol and/or other drug abuse services, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29899","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["95"]}],"provider_references":[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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"51701","name":"Insert bladder catheter","description":"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61597","name":"Transcondylar approach/skull","description":"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of c1-c3 vertebral body(s), decompression of vertebral artery, with or without mobilization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"Vnpnxr<3yrs phy/qhp other vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; other vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8750.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19306","name":"Mast rad urban type","description":"Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (urban type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62362","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49084","name":"Peritoneal lavage","description":"Peritoneal lavage, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22848","name":"Insert pelv fixation device","description":"Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83897","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8699.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53260","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral polyp(s), distal urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28305","name":"Incise/graft midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes obtaining graft) (eg, fowler type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47541","name":"Plmt access bil tree sm bwl","description":"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological superv","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40510","name":"Partial excision of lip","description":"Excision of lip; transverse wedge excision with primary closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90911","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61253","name":"Burr hole treph ittl uni/bi","description":"Burr hole(s) or trephine, infratentorial, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27394","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, 1 leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58345","name":"Reopen fallopian tube","description":"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37766","name":"Phleb veins - extrem 20+","description":"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44151","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, without proctectomy; with continent ileostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62140","name":"Crnop skull defect<5 cm diam","description":"Cranioplasty for skull defect; up to 5 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4245","name":"Alcohol wipes per box","description":"Alcohol wipes, per box","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87550","name":"Mycobacteria dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22533.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86328","name":"Ia nfct ab sarscov2 covid19","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36011","name":"Place catheter in vein","description":"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19086","name":"Bx breast add lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26416","name":"Graft hand or finger tendon","description":"Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, each rod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87591","name":"N.gonorrhoeae dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"80417","name":"Renin stimulation panel","description":"Peripheral vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403T","name":"Diabetes prev standard curr","description":"Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28041","name":"Exc foot/toe tum dep 1.5cm/>","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3362.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35884","name":"Revj fem anast autog vn grf","description":"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82820","name":"Hemoglobin-oxygen affinity","description":"Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26541","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26115","name":"Exc hand les sc < 1.5 cm","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35303","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; popliteal artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41800","name":"Drainage of gum lesion","description":"Drainage of abscess, cyst, hematoma from dentoalveolar structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62351","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57423","name":"Repair paravag defect lap","description":"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82657","name":"Enzyme cell activity","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33416","name":"Revise ventricle muscle","description":"Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10004","name":"Fna bx w/o img gdn ea addl","description":"Fine needle aspiration biopsy, without imaging guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67314","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31634","name":"Bronch w/balloon occlusion","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66761","name":"Revision of iris","description":"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3252","name":"Shoe molded plastazote cust","description":"Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61783","name":"Scan proc spinal","description":"Stereotactic computer-assisted (navigational) procedure; spinal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4726","name":"Dialys sol fld vol > 5999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29862","name":"Hip arthr0 w/debridement","description":"Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33263","name":"Rmvl & rplcmt dfb gen 2 lead","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19285","name":"Perq dev breast 1st us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94003","name":"Vent mgmt inpat subq day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, each subsequent day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6284.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30115","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), extensive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61692","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23485","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24655","name":"Cltx rdl head/nck fx w/mnpj","description":"Closed treatment of radial head or neck fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33675","name":"Close mult vsd","description":"Closure of multiple ventricular septal defects;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1715.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25545","name":"Optx ulnar shft fx int fixj","description":"Open treatment of ulnar shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33415","name":"Revision subvalvular tissue","description":"Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88285","name":"Chromosome count additional","description":"Chromosome analysis; additional cells counted, each study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28226","name":"Release of foot tendons","description":"Tenolysis, extensor, foot; multiple tendons","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54332","name":"Revise penis/urethra","description":"1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92563","name":"Tone decay hearing test","description":"Tone decay test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27215","name":"Treat pelvic fracture(s)","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0115","name":"Post-coital mucous exam","description":"Post-coital direct, qualitative examinations of vaginal or cervical mucous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14747.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96542","name":"Chemotherapy injection","description":"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4208","name":"3 cc sterile syringe&needle","description":"Syringe with needle, sterile 3 cc, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49465","name":"Fluoro exam of g/colon tube","description":"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15756","name":"Free myo/skin flap microvasc","description":"Free muscle or myocutaneous flap with microvascular anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82666","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26567","name":"Correct finger deformity","description":"Osteotomy; phalanx of finger, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483T","name":"Tmvi percutaneous approach","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"52352","name":"Cystouretero w/stone remove","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92961","name":"Cardioversion electric int","description":"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4465","name":"Non-elastic extremity binder","description":"Non-elastic binder for extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85247","name":"Clot factor viii multimetric","description":"Clotting; factor viii, von willebrand factor, multimetric analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22116","name":"Remove extra spine segment","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20604","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84302","name":"Assay of sweat sodium","description":"Sodium; other source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57155","name":"Insert uteri tandem/ovoids","description":"Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63305","name":"Remove vert idrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5475.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0236T","name":"Trluml perip athrc abd aorta","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; abdominal aorta","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87503","name":"Influenza dna amp prob addl","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, each additional influenza virus type or sub-type beyond 2 (list separately in addition to code","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"11621","name":"Exc s/n/h/f/g mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25136","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27681","name":"Release of lower leg tendons","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incision[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9507","name":"In111 capromab","description":"Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58554","name":"Laparo-vag hyst w/t/o compl","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32604","name":"Thoracoscopy wbx sac","description":"Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21080","name":"Impres&prep def obt prosth","description":"Impression and custom preparation; definitive obturator prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11402","name":"Exc tr-ext b9+marg 1.1-2 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44340","name":"Revision of colostomy","description":"Revision of colostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22532","name":"Arthrd lat xtrcvtry tq thrc","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6309.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37229","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17315","name":"Mohs surg addl block","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), e","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35721","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30110","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99360","name":"Physician standby services","description":"Standby service, requiring prolonged attendance, each 30 minutes (eg, operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring eeg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98968","name":"Ph1 assmt&mgmt nqhp 21-30","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0402T","name":"Colgn crs-link crn&pachymtry","description":"Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"H2019","name":"Ther behav svc, per 15 min","description":"Therapeutic behavioral services, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U5"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33688","name":"Clsr 1vsd w/wo ptch rmvl bnd","description":"Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27222","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25035","name":"Inc dp bone crtx f/arm&/wrst","description":"Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31395","name":"Reconstruct larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; with reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2241.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77422","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87332","name":"Cytomegalovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cytomegalovirus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11363.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35876","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49080","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78464","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33203","name":"Insert epicard eltrd endo","description":"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82030","name":"Assay of adp & amp","description":"Adenosine, 5-monophosphate, cyclic (cyclic amp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43213","name":"Esophagoscopy retro balloon","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66183","name":"Insert ant drainage device","description":"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8270","name":"Enuresis alarm","description":"Enuresis alarm, using auditory buzzer and/or vibration device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23222","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57268","name":"Repair of bowel bulge","description":"Repair of enterocele, vaginal approach (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54110","name":"Treatment of penis lesion","description":"Excision of penile plaque (peyronie disease);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3526.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20916.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61321","name":"Crnec/crnot drg icr abs ittl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4606","name":"Oxygen probe used w oximeter","description":"Oxygen probe for use with oximeter device, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31235","name":"Nsl/sins ndsc dx sphn sinusc","description":"Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0441","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57220","name":"Revision of urethra","description":"Plastic operation on urethral sphincter, vaginal approach (eg, kelly urethral plication)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47145","name":"Prep donor liver lobe split","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe spli","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33519","name":"Cabg artery-vein three","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38215","name":"Harvest stem cell concentrte","description":"Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96411","name":"Chemo iv push addl drug","description":"Chemotherapy administration; intravenous, push technique, each additional substance/drug (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4103","name":"Ef ped fluid and electrolyte","description":"Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15787","name":"Abrasion lesions add-on","description":"Abrasion; each additional 4 lesions or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95831","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77032","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59076","name":"Fetal shunt placement w/us","description":"Fetal shunt placement, including ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87400","name":"Influenza a/b each ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; influenza, a or b, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20985","name":"Cptr-asst dir ms px","description":"Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44705","name":"Prepare fecal microbiota","description":"Preparation of fecal microbiota for instillation, including assessment of donor specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6967.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26390","name":"Revise hand/finger tendon","description":"Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67332","name":"Rerevise eye muscles add-on","description":"Strabismus surgery on patient with scarring of extraocular muscles (eg, prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (eg, dysthyroid ophthalmopathy) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28456","name":"Prq skel fix tarsl fx w/mnpj","description":"Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29915","name":"Hip arthro acetabuloplasty","description":"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9987","name":"Bpci advanced in home visit","description":"Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/am","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44212","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1628.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95700","name":"Eeg cont rec w/vid eeg tech","description":"Electroencephalogram (eeg) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by eeg technologist, minimum of 8 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86788","name":"West nile virus ab igm","description":"Antibody; west nile virus, igm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3221","name":"Orthopedic mens shoes dpth i","description":"Orthopedic footwear, mens shoe, depth inlay, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33883","name":"Delayed plmt prox xtn prosth","description":"Delayed placement of proximal extension prosthesis(es) not involving coverage of the left subclavian artery origin, after endovascular repair of the thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and inter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3160","name":"Shoe styled positioning dev","description":"Foot, adjustable shoe-styled positioning device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4347.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22328","name":"Treat each add spine fx","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2551.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60200","name":"Remove thyroid lesion","description":"Excision of cyst or adenoma of thyroid, or transection of isthmus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61558","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21461","name":"Optx mndblr fx wo ntrdntl","description":"Open treatment of mandibular fracture; without interdental fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25490","name":"Prophylactic tx radius","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11600","name":"Exc tr-ext mal+marg 0.5 cm/<","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"14021","name":"Tis trnfr s/a/l 10.1-30 sqcm","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1499","name":"Spinal orthosis nos","description":"Spinal orthosis, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64886","name":"Nerve graft head/neck >4 cm","description":"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81184","name":"Cacna1a gen detc abnor allel","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6000","name":"Wound warming wound cover","description":"Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67835","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin, with free mucous membrane graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58270","name":"Vag hyst w/enterocele repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40701","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27814","name":"Treatment of ankle fracture","description":"Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9609.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0147","name":"Scr c/v cyto, automated sys","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96932","name":"Rcm img acquisj only 1st les","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27198","name":"Clsd tx pelvic ring fx","description":"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; with ma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33958","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35566","name":"Art byp fem-ant-post tib/prl","description":"Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23620","name":"Cltx gr hmrl tbrs fx wo mnpj","description":"Closed treatment of greater humeral tuberosity fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92571","name":"Filtered speech test","description":"Filtered speech test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47800","name":"Reconstruction of bile ducts","description":"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43600","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15776","name":"Hair trnspl >15 punch grafts","description":"Punch graft for hair transplant; more than 15 punch grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42836","name":"Removal of adenoids","description":"Adenoidectomy, secondary; age 12 or over","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25300","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; flexors of fingers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95144","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86885","name":"Coombs test indirect qual","description":"Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69642","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"69421","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50660","name":"Removal of ureter","description":"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0222T","name":"Plmt post facet implt addl","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93668","name":"Peripheral vascular rehab","description":"Peripheral arterial disease (pad) rehabilitation, per session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0081","name":"Care man h v ext pt 20 mi","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28192","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; deep","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27499","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33951","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33694","name":"Cmp rpr tof wo plm atrs ptch","description":"Complete repair tetralogy of fallot without pulmonary atresia; with transannular patch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6200","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00561","name":"Anes px heart w/pump<1 yr","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31530","name":"Laryngoscopy w/fb removal","description":"Laryngoscopy, direct, operative, with foreign body removal;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82978","name":"Assay of glutathione","description":"Glutathione","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83519","name":"Ria nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, ria)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25215","name":"Removal of wrist bones","description":"Carpectomy; all bones of proximal row","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43848","name":"Revj open gstr rstcv px","description":"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44385","name":"Endoscopy of bowel pouch","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77411","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35180","name":"Rpr cgen av fistula head&nck","description":"Repair, congenital arteriovenous fistula; head and neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92590","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43214","name":"Esophagosc dilate balloon 30","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50431","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3790.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31293","name":"Nsl/sins ndsc med&inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28022","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61750","name":"Incise skull/brain biopsy","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34704","name":"Evasc rpr a-unilac ndgft rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22843","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15155","name":"Tis cltr agrft f/s/n/h/f/g 1","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95028","name":"Iq tsts allergy delayed rxn","description":"Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"92201","name":"Opscpy extnd rta draw uni/bi","description":"Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (eg, for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31230","name":"Removal of upper jaw","description":"Maxillectomy; with orbital exenteration (en bloc)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33419","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66985","name":"Insert lens prosthesis","description":"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20916.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43219","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87269","name":"Giardia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; giardia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77071","name":"Mnl appl strs jt radiography","description":"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37183","name":"Revision tips","description":"Revision of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannulization/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90997","name":"Hemoperfusion","description":"Hemoperfusion (eg, with activated charcoal or resin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87046","name":"Stool cultr aerobic bact ea","description":"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64410","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26844","name":"Fusion/graft of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55720","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22819","name":"Kyphectomy 3 or more","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57109","name":"Vagnc bi total pel lymphadec","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90821","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95990","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"T4530","name":"Ped size brief/diaper lg","description":"Pediatric sized disposable incontinence product, brief/diaper, large size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"H0016","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"38572","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17271","name":"Dstr mal les s/n/h/f/g 0.6-1","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34421","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26755","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54400","name":"Insert semi-rigid prosthesis","description":"Insertion of penile prosthesis; non-inflatable (semi-rigid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68816","name":"Probe nl duct w/balloon","description":"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10036","name":"Plmt sft tiss loclzj dev ea","description":"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11721","name":"Debride nail 6 or more","description":"Debridement of nail(s) by any method(s); 6 or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81305","name":"Myd88 gene p.leu265pro vrnt","description":"Myd88 (myeloid differentiation primary response 88) (eg, waldenstroms macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.leu265pro (l265p) variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56633","name":"Vulvectomy radical complete","description":"Vulvectomy, radical, complete;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55725","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10509","10512","10516","10524","10537","10541","10542","10579","10910","10912","10914","10915","10916","10917","10918","10919","10921","10922","10924","10925","10926","10928","10930","10932","10933","10940","10941","10943","10949","10950","10953","10958","10959","10963","10969","10973","10975","10979","10981","10985","10987","10988","10990","10992","10996","10997","10998","12015","12017","12029","12037","12042","12050","12051","12058","12060","12075","12083","12087","12106","12115","12124","12125","12130","12132","12136","12165","12167","12172","12173","12174","12176","12184","12192","12195","12401","12402","12404","12405","12406","12407","12409","12410","12411","12412","12413","12414","12416","12417","12418","12419","12420","12421","12422","12423","12424","12427","12428","12429","12430","12431","12432","12433","12434","12435","12436","12438","12439","12440","12441","12442","12443","12444","12446","12448","12449","12450","12451","12452","12453","12454","12455","12456","12457","12458","12459","12460","12461","12463","12464","12465","12466","12468","12470","12471","12472","12473","12474","12475","12477","12480","12481","12482","12483","12484","12485","12486","12487","12489","12490","12491","12492","12493","12494","12495","12496","12498","12501","12502","12503","12504","12506","12507","12508","12510","12511","12512","12513","12514","12515","12516","12517","12518","12520","12521","12522","12523","12524","12525","12526","12527","12528","12529","12530","12531","12533","12534","12537","12538","12540","12541","12542","12543","12544","12545","12546","12547","12548","12549","12550","12551","12552","12553","12555","12561","12563","12564","12565","12566","12567","12568","12569","12570","12571","12572","12574","12575","12577","12578","12580","12581","12582","12583","12584","12585","12586","12588","12589","12590","12592","12593","12594","12601","12602","12603","12604","12701","12719","12720","12721","12722","12723","12724","12725","12726","12727","12729","12732","12733","12734","12736","12737","12738","12740","12741","12742","12743","12745","12746","12747","12748","12749","12750","12751","12752","12754","12758","12759","12760","12762","12763","12764","12765","12766","12767","12768","12769","12770","12771","12775","12776","12777","12778","12779","12780","12781","12782","12783","12784","12785","12786","12787","12788","12789","12790","12791","12792","13731","13739","13740","13750","13751","13752","13753","13755","13756","13757","13774","13775","13782","13783","13786","13788","13804","13806","13837","13838","13839","13842","13846","13847","13856","13860"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86747","name":"Parvovirus antibody","description":"Antibody; parvovirus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31085","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2055.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25660","name":"Cltx rdcrpl/ntrcrpl dislc 1+","description":"Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36248","name":"Ins cath abd/l-ext art addl","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52325","name":"Cystoscopy stone removal","description":"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69405","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0472T","name":"Prgrmg io rta eltrd ra","description":"Device evaluation, interrogation, and initial programming of intraocular retinal electrode array (eg, retinal prosthesis), in person, with iterative adjustment of the implantable device to test functionality, select optimal permanent programmed values with analysis, including visual training, with r","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22526","name":"Idet single level","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99155","name":"Mod sed oth phys/qhp <5 yrs","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger th","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L8010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44203","name":"Lap resect s/intestine addl","description":"Laparoscopy, surgical; each additional small intestine resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29867","name":"Allgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0310","name":"Immunize counsel 5-15 min","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22224","name":"Osteot dsc ant 1vrt sgm lmbr","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3909","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81336","name":"Smn1 gene full gene sequence","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93228","name":"Remote 30 day ecg rev/report","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65426","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59136","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0166","name":"Extrnl counterpulse, per tx","description":"External counterpulsation, per treatment session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47630","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22848","name":"Insert pelv fixation device","description":"Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23073","name":"Exc shoulder tum deep 5 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27894","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54700","name":"I&d epdidyms tstis&/scrot sp","description":"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87799","name":"Detect agent nos dna quant","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; quantification, each organism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28126","name":"Partial removal of toe","description":"Resection, partial or complete, phalangeal base, each toe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","AU","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33511","name":"Cabg vein two","description":"Coronary artery bypass, vein only; 2 coronary venous grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96105","name":"Assessment of aphasia","description":"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by boston diagnostic aphasia examination) with interpretation and report, per hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41105","name":"Biopsy of tongue","description":"Biopsy of tongue; posterior one-third","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35474","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3037.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87269","name":"Giardia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; giardia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61534","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8052.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32655","name":"Thoracoscopy resect bullae","description":"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8686","name":"Implt nrostm pls gen sng non","description":"Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33250","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15115","name":"Epdrm agrft f/s/n/h/f/g/m 1","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2474.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35509","name":"Art byp grft contral carotid","description":"Bypass graft, with vein; carotid-contralateral carotid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3001.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63076","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20680","name":"Removal of implant deep","description":"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67911","name":"Revise eyelid defect","description":"Correction of lid retraction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86886","name":"Coombs test indirect titer","description":"Antihuman globulin test (coombs test); indirect, each antibody titer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12054","name":"Intmd rpr face/mm 7.6-12.5cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25622","name":"Cltx carpl scphd fx w/o mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82540","name":"Assay of creatine","description":"Creatine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35121","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36218","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92012","name":"Intrm oph exam est patient","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35491","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61868","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; each additional ar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67036","name":"Removal of inner eye fluid","description":"Vitrectomy, mechanical, pars plana approach;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"66990","name":"Ophthalmic endoscope add-on","description":"Use of ophthalmic endoscope (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25332","name":"Revise wrist joint","description":"Arthroplasty, wrist, with or without interposition, with or without external or internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26756","name":"Pin finger fracture each","description":"Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15121","name":"Splt agrft f/s/n/h/f/g/m ea","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54162","name":"Lysis penil circumic lesion","description":"Lysis or excision of penile post-circumcision adhesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5067.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69220","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67041","name":"Vit for macular pucker","description":"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64892","name":"Nrv grf 1strnd arm/leg <4cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64561","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64573","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68325","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4489.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71090","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54105","name":"Biopsy of penis","description":"Biopsy of penis; deep structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23078","name":"Rad rescj tum shoulder 5cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35305","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83789","name":"Mass spectrometry qual/quan","description":"Mass spectrometry and tandem mass spectrometry (eg, ms, ms/ms, maldi, ms-tof, qtof), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33221","name":"Insert pulse gen mult leads","description":"Insertion of pacemaker pulse generator only; with existing multiple leads","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86807","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); standard method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2531.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1809.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15860","name":"Iv njx tst vasc flo flap/grf","description":"Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5706.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54600","name":"Reduce testis torsion","description":"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82642","name":"Dihydrotestosterone","description":"Dihydrotestosterone (dht)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78588","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35493","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87340","name":"Hepatitis b surface ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26591","name":"Repair muscles of hand","description":"Repair, intrinsic muscles of hand, each muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25272","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64834","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; hand or foot, common sensory nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5546.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25110","name":"Remove wrist tendon lesion","description":"Excision, lesion of tendon sheath, forearm and/or wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36903","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61791","name":"Treat trigeminal tract","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17107","name":"Dstr cut vsc prlf les10-50sq","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29280","name":"Strapping of hand or finger","description":"Strapping; hand or finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A9537","name":"Tc99m mebrofenin","description":"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9603","name":"One-way allow prorated miles","description":"Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47720","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; direct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15825","name":"Rhytdct nck pltysml tghtg","description":"Rhytidectomy; neck with platysmal tightening (platysmal flap, p-flap)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"98971","name":"Nqhp ol dig assmt&mgmt 11-20","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99190","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); each hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12208.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21600","name":"Partial removal of rib","description":"Excision of rib, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43206","name":"Esoph optical endomicroscopy","description":"Esophagoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11303","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15321","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0642","name":"Dynamic standing frame","description":"Standing frame/table system, mobile (dynamic stander), any size including pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47555","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) without stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4231","name":"Infusion insulin pump needle","description":"Infusion set for external insulin pump, needle type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5480.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4023.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"94240","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27758","name":"Treatment of tibia fracture","description":"Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2004","name":"Post-d/c h vst new pt 60 m","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient faci","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28310","name":"Revision of big toe","description":"Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28120","name":"Part removal of ankle/heel","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37607","name":"Lig/banding angioacs av fstl","description":"Ligation or banding of angioaccess arteriovenous fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58294","name":"Vag hyst w/enterocele compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21743","name":"Repair sternum/nuss w/scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), with thoracoscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64445","name":"Njx aa&/strd sciatic nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98980","name":"Rtm tx mgmt 1st 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27532","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28298","name":"Cor hlx vlgs prx phlx osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95711","name":"Veeg 2-12 hr unmonitored","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; unmonitored","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84181","name":"Western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90581","name":"Anthrax vaccine sc or im","description":"Anthrax vaccine, for subcutaneous or intramuscular use","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87905","name":"Ia nzmtc actv oth/thn virus","description":"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41007","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61608","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A0425","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","22"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39545","name":"Revision of diaphragm","description":"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"88269","name":"Chromosome analys amniotic","description":"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33208","name":"Insrt heart pm atrial & vent","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82544","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4203.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52234","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; small bladder tumor(s) (0.5 up to 2.0 cm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24516","name":"Tx humrl shaft fx imed implt","description":"Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27829","name":"Treat lower leg joint","description":"Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82553","name":"Creatine mb fraction","description":"Creatine kinase (ck), (cpk); mb fraction only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35637","name":"Bpg aortoiliac","description":"Bypass graft, with other than vein; aortoiliac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44227","name":"Lap close enterostomy","description":"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49406","name":"Image cath fluid peri/retro","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82784","name":"Assay iga/igd/igg/igm each","description":"Gammaglobulin (immunoglobulin); iga, igd, igg, igm, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32402","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22867","name":"Insj stablj dev w/dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36252","name":"Ins cath ren art 1st bilat","description":"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and inte","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54437","name":"Repair corporeal tear","description":"Repair of traumatic corporeal tear(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12056","name":"Intmd rpr face/mm 20.1-30.0","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96156","name":"Hlth bhv assmt/reassessment","description":"Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69955","name":"Release facial nerve","description":"Total facial nerve decompression and/or repair (may include graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22845","name":"Insert spine fixation device","description":"Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61458","name":"Crnec sopl xpl/dcmpr crl nrv","description":"Craniectomy, suboccipital; for exploration or decompression of cranial nerves","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61320","name":"Crnec/crnot drg icr abs sttl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92974","name":"Cath place cardio brachytx","description":"Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99491","name":"Chrnc care mgmt phys 1st 30","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83550","name":"Iron binding test","description":"Iron binding capacity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11755.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86001","name":"Allergen specific igg","description":"Allergen specific igg quantitative or semiquantitative, each allergen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19342","name":"Insj/rplcmt brst implt sep d","description":"Insertion or replacement of breast implant on separate day from mastectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61538","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93248","name":"Ext ecg>7d<15d rev&interpj","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; review and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3733.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22207","name":"Incis spine 3 column lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3674.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12051","name":"Intmd rpr face/mm 2.5 cm/<","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42160","name":"Treatment mouth roof lesion","description":"Destruction of lesion, palate or uvula (thermal, cryo or chemical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26205","name":"Remove/graft bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57311","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula; with bulbocavernosus transplant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0078","name":"Care manag h vst new pt 45 m","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4232","name":"Syringe w/needle insulin 3cc","description":"Syringe with needle for external insulin pump, sterile, 3 cc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64415","name":"Njx aa&/strd brch plxs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2214","name":"Init/sub psych care m 1st 30","description":"Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23655","name":"Cltx sho dslc w/mnpj w/anes","description":"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3112.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9955","name":"Inj perflexane lip micros,ml","description":"Injection, perflexane lipid microspheres, per ml","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82696","name":"Assay of etiocholanolone","description":"Etiocholanolone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19330","name":"Rmvl ruptured breast implant","description":"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11004","name":"Dbrdmt skin xtrnl gent&per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9686","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4660","name":"Sphyg/bp app w cuff and stet","description":"Sphygmomanometer/blood pressure apparatus with cuff and stethoscope","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1501.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36010","name":"Place catheter in vein","description":"Introduction of catheter, superior or inferior vena cava","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20900","name":"Removal of bone for graft","description":"Bone graft, any donor area; minor or small (eg, dowel or button)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4153","name":"Ef hydrolyzed/amino acids","description":"Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58674","name":"Laps abltj uterine fibroids","description":"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1416.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50220","name":"Remove kidney open","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37216","name":"Transcath stent cca w/o eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65771","name":"Radial keratotomy","description":"Radial keratotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, manual","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83788","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27508","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0208T","name":"Audiometry air only","description":"Pure tone audiometry (threshold), automated; air only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95131","name":"Immntx 2 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 stinging insect venoms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33228","name":"Remv&replc pm gen dual lead","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89310","name":"Semen analysis w/count","description":"Semen analysis; motility and count (not including huhner test)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25520","name":"Cltx rdl shft fx&dislc","description":"Closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (galeazzi fracture/dislocation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0576T","name":"Interrog dev eval icds ss ip","description":"Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44300","name":"Open bowel to skin","description":"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50957","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54312","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29893","name":"Endoscopic plantr fasciotomy","description":"Endoscopic plantar fasciotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97530","name":"Therapeutic activities","description":"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31654","name":"Bronch ebus ivntj perph les","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (list separately in addition to code for primary procedure[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24331","name":"Flexor-plasty elbw w/advmnt","description":"Flexor-plasty, elbow (eg, steindler type advancement); with extensor advancement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93012","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46608","name":"Anoscopy remove for body","description":"Anoscopy; with removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80415","name":"Tot estradiol response panel","description":"Chorionic gonadotropin stimulation panel; estradiol response this panel must include the following: estradiol, total (82670 x 2 on 3 pooled blood samples)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44626","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88325","name":"Consltj compre rvw rec reprt","description":"Consultation, comprehensive, with review of records and specimens, with report on referred material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"R0075","name":"Transport port x-ray multipl","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93228","name":"Remote 30 day ecg rev/report","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2274.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21510","name":"Inc deep opng b1 crtx thorax","description":"Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43278","name":"Ercp lesion ablate w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33411","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2929.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75994","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25248","name":"Remove forearm foreign body","description":"Exploration with removal of deep foreign body, forearm or wrist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82252","name":"Fecal bilirubin test","description":"Bilirubin; feces, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62350","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90818","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35647","name":"Bpg aortofemoral","description":"Bypass graft, with other than vein; aortofemoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64736","name":"Incision of chin nerve","description":"Transection or avulsion of; mental nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94642","name":"Aerosol inhalation treatment","description":"Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86063","name":"Antistreptolysin o screen","description":"Antistreptolysin 0; screen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0144","name":"Azithromycin dihydrate, oral","description":"Azithromycin dihydrate, oral, capsules/powder, 1 gram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92579","name":"Visual audiometry (vra)","description":"Visual reinforcement audiometry (vra)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67903","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43335","name":"Transthor diaphrag hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47535","name":"Conversion ext bil drg cath","description":"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37185","name":"Prim art m-thrmbc sbsq vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (list separa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12017","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67041","name":"Vit for macular pucker","description":"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97161","name":"Pt eval low complex 20 min","description":"Physical therapy evaluation: low complexity, requiring these components: a history with no personal factors and/or comorbidities that impact the plan of care; an examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11420","name":"Exc h-f-nk-sp b9+marg 0.5/<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35703","name":"Expl n/flwd surg lxtr art","description":"Exploration not followed by surgical repair, artery; lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87487","name":"Chlmyd pneum dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85337","name":"Thrombomodulin","description":"Thrombomodulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64412","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33471","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67835","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin, with free mucous membrane graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87541","name":"Legion pneumo dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84252","name":"Assay of vitamin b-2","description":"Riboflavin (vitamin b-2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27676","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; with fibular osteotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27134","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; both components, with or without autograft or allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87581","name":"M.pneumon dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55400","name":"Repair of sperm duct","description":"Vasovasostomy, vasovasorrhaphy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99324","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46900","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83625","name":"Assay of ldh enzymes","description":"Lactate dehydrogenase (ld), (ldh); isoenzymes, separation and quantitation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14300","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3315.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9432.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21012","name":"Exc face les sbq 2 cm/>","description":"Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22326","name":"Treat neck spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15771","name":"Grfg autol fat lipo 50 cc/<","description":"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25100","name":"Biopsy of wrist joint","description":"Arthrotomy, wrist joint; with biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93652","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47612","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with choledochoenterostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54401","name":"Insert self-contd prosthesis","description":"Insertion of penile prosthesis; inflatable (self-contained)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81120","name":"Idh1 common variants","description":"Idh1 (isocitrate dehydrogenase 1 [nadp+], soluble) (eg, glioma), common variants (eg, r132h, r132c)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44373","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["11004","11005","11101","11102","11103","11104","11105","11106","11109","11120","11351","11352","11354","11355","11356","11357","11358","11359","11360","11361","11362","11363","11364","11365","11366","11367","11368","11369","11370","11371","11372","11373","11374","11375","11377","11378","11379","11380","11381","11385","11386","11390","11405","11411","11412","11413","11414","11415","11416","11417","11418","11419","11420","11421","11422","11423","11424","11425","11426","11427","11428","11429","11430","11431","11432","11433","11434","11435","11436","11437","11439","11451","11499","11690","11691","11692","11693","11694","11695","11697"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61682","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"Esrd srv 4 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2587.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26260","name":"Resect prox finger tumor","description":"Radical resection of tumor, proximal or middle phalanx of finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33820","name":"Repair pda by ligation","description":"Repair of patent ductus arteriosus; by ligation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26125","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft); each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61608","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2956.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4341.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27441","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1832.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24363","name":"Replace elbow joint","description":"Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43251","name":"Egd remove lesion snare","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94777","name":"Ped home apnea mntr rvw i&r","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43122","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2015","name":"Post-d/c care plan overs 60m","description":"Comprehensive (60 mins) home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0425","name":"Inpt/ed teleconsult30","description":"Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28122","name":"Partial removal of foot bone","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61535","name":"Remove brain electrodes","description":"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17286","name":"Dstr mal ls f/e/e/n/l/m>4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50930","name":"Closure ureter/bowel fistula","description":"Closure of ureterovisceral fistula (including visceral repair)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21255","name":"Reconstruct lower jaw bone","description":"Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90480","name":"Admn sarscov2 vac 1/only cmp","description":"Immunization administration by intramuscular injection, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine; first or only component of each vaccine administered","date_of_service":"2026-06-06","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":["CSTM-00"],"billing_code_modifier":["HA"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64831","name":"Repair of digit nerve","description":"Suture of digital nerve, hand or foot; 1 nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35703","name":"Expl n/flwd surg lxtr art","description":"Exploration not followed by surgical repair, artery; lower extremity (eg, common femoral, deep femoral, superficial femoral, popliteal, tibial, peroneal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"H0005","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; group counseling by a clinician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4222","name":"Parenteral supply kit homemi","description":"Parenteral nutrition supply kit; home mix, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43257","name":"Egd w/thrml txmnt gerd","description":"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28104","name":"Removal of foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92625","name":"Tinnitus assessment","description":"Assessment of tinnitus (includes pitch, loudness matching, and masking)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64761","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5642.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34832","name":"Open aortofemor prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31770","name":"Repair/graft of bronchus","description":"Bronchoplasty; graft repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47505","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27630","name":"Removal of tendon lesion","description":"Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1548.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64636","name":"Destroy l/s facet jnt addl","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, each additional facet joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7830.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77032","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42210","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4978.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33814","name":"Obltrj a-pulm sep def w/byp","description":"Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87255","name":"Genet virus isolate hsv","description":"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92532","name":"Positional nystagmus test","description":"Positional nystagmus test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4189","name":"Parenteral sol amino acid &","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53661","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34843","name":"Endovasc visc aorta 3 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29730","name":"Windowing of cast","description":"Windowing of cast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77413","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80402","name":"Acth stimulation panel","description":"Acth stimulation panel; for 21 hydroxylase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82646","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89141","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28294","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43266","name":"Egd endoscopic stent place","description":"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28070","name":"Removal of foot joint lining","description":"Synovectomy; intertarsal or tarsometatarsal joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46610","name":"Anoscopy remove lesion","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82507","name":"Assay of citrate","description":"Citrate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0249T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68020","name":"Incise/drain eyelid lining","description":"Incision of conjunctiva, drainage of cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4868.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43810","name":"Gastroduodenostomy","description":"Gastroduodenostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27422","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, campbell, goldwaite type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88329","name":"Path consltj drg surg","description":"Pathology consultation during surgery;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22610","name":"Arthrd pst tq 1ntrspc thrc","description":"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43860","name":"Revj gstr/jj anast w/o vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; without vagotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4930","name":"Sterile, gloves per pair","description":"Gloves, sterile, per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96168","name":"Hlth bhv ivntj fam ea addl","description":"Health behavior intervention, family (with the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33871","name":"Transvrs a-arch grf hypthrm","description":"Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia, total circulatory arrest and isolated cerebral perfusion with reimplantation of arch vessel(s) (eg, island pedicle or individual arch vessel reimplantation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95721","name":"Eeg phy/qhp>36<60 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of eeg recording, without video","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99469","name":"Neonate crit care subsq","description":"Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22864","name":"Rmvl tot arthrp 1ntrspc crv","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26450","name":"Incision of palm tendon","description":"Tenotomy, flexor, palm, open, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9490","name":"Cmmi mod home visit","description":"Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/man","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308T","name":"Insj ocular telescope prosth","description":"Insertion of ocular telescope prosthesis including removal of crystalline lens or intraocular lens prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44605","name":"Repair of bowel lesion","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); with colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80305","name":"Drug test prsmv dir opt obs","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50706","name":"Balloon dilate urtrl strix","description":"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88249","name":"Chromosome analysis 100","description":"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin c, ionizing radiation, uv radiation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44373","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32096","name":"Open wedge/bx lung infiltr","description":"Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23220","name":"Radical rescj tumor prox hum","description":"Radical resection of tumor, proximal humerus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42953","name":"Repair throat esophagus","description":"Pharyngoesophageal repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92605","name":"Ex for nonspeech device rx","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"19085","name":"Bx breast 1st lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77071","name":"Mnl appl strs jt radiography","description":"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63300","name":"Remove vert xdrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0394","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44133","name":"Enterectomy live donor","description":"Donor enterectomy (including cold preservation), open; partial, from living donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86038","name":"Antinuclear antibodies","description":"Antinuclear antibodies (ana);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32097","name":"Open wedge/bx lung nodule","description":"Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25441","name":"Arthrp w/prostc dstl rds","description":"Arthroplasty with prosthetic replacement; distal radius","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43774","name":"Lap rmvl gastr adj all parts","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28309","name":"Incision of metatarsals","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; multiple (eg, swanson type cavus foot procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97532","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64874","name":"Repair & revise nerve add-on","description":"Suture of nerve; requiring extensive mobilization, or transposition of nerve (list separately in addition to code for nerve suture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77414","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57282","name":"Colpopexy extraperitoneal","description":"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0191","name":"Misoprostol, oral, 200 mcg","description":"Misoprostol, oral, 200 mcg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0027","name":"Semen analysis","description":"Semen analysis; presence and/or motility of sperm excluding huhner","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43502","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, mallory-weiss)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25645","name":"Optx crpl fx oth/thn scph ea","description":"Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42281","name":"Insertion palate prosthesis","description":"Insertion of pin-retained palatal prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51710","name":"Change of bladder tube","description":"Change of cystostomy tube; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65880","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60300","name":"Aspir/inj thyroid cyst","description":"Aspiration and/or injection, thyroid cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63173","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92342","name":"Fit spectacles multifocal","description":"Fitting of spectacles, except for aphakia; multifocal, other than bifocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41018","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2001","name":"Post d/c h vst new pt 20 m","description":"Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93297","name":"Rem interrog dev eval icpms","description":"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other quali","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87622","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84445","name":"Assay of tsi globulin","description":"Thyroid stimulating immune globulins (tsi)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31295","name":"Nsl/sins ndsc surg max sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43248","name":"Egd guide wire insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24615","name":"Optx aqt/chrnc elbow dislc","description":"Open treatment of acute or chronic elbow dislocation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64870","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27784","name":"Treatment of fibula fracture","description":"Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33321","name":"Repair major vessel","description":"Suture repair of aorta or great vessels; with shunt bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29905","name":"Subtalar arthro w/exc","description":"Arthroscopy, subtalar joint, surgical; with synovectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25136","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512T","name":"Esw integ wnd hlg 1st wnd","description":"Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2058","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44340","name":"Revision of colostomy","description":"Revision of colostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63663","name":"Revise spine eltrd perq aray","description":"Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50386","name":"Remove stent via transureth","description":"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0070","name":"Transport portable x-ray","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0898","name":"Power wheelchair noc","description":"Power wheelchair, not otherwise classified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29566.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32815","name":"Close bronchial fistula","description":"Open closure of major bronchial fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1748.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21825","name":"Treat sternum fracture","description":"Open treatment of sternum fracture with or without skeletal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27687","name":"Revision of calf tendon","description":"Gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21145","name":"Rcnstj mdfc lefort i 1 w/grf","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31300","name":"Removal of larynx lesion","description":"Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439T","name":"Myocrd contrast prfuj echo","description":"Myocardial contrast perfusion echocardiography, at rest or with stress, for assessment of myocardial ischemia or viability (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11770","name":"Exc pilonidal cyst simple","description":"Excision of pilonidal cyst or sinus; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58953","name":"Tah rad dissect for debulk","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35481","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25651","name":"Perq skel fix ulnar styld fx","description":"Percutaneous skeletal fixation of ulnar styloid fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38790","name":"Inject for lymphatic x-ray","description":"Injection procedure; lymphangiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87350","name":"Hepatitis be ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis be antigen (hbeag)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27095","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; with anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93233","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43820","name":"Gastrojejunostomy wo vagotmy","description":"Gastrojejunostomy; without vagotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52305","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31638","name":"Bronchoscopy revise stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with revision of tracheal or bronchial stent inserted at previous session (includes tracheal/bronchial dilation as required)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36595","name":"Mech remov tunneled cv cath","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93244","name":"Ext ecg>48hr<7d rev&interpj","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82145","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27726","name":"Repair fibula nonunion","description":"Repair of fibula nonunion and/or malunion with internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54437","name":"Repair corporeal tear","description":"Repair of traumatic corporeal tear(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15273","name":"Skin sub grft t/arm/lg child","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37239","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11620","name":"Exc h-f-nk-sp mal+marg 0.5/<","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26235","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99225","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54340","name":"Rpr hypspad comp simple","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24115","name":"Exc/crtg b1 cst/tum hum agrf","description":"Excision or curettage of bone cyst or benign tumor, humerus; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41150","name":"Tongue mouth jaw surgery","description":"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15176","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11921","name":"Correct skn color 6.1-20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84238","name":"Assay nonendocrine receptor","description":"Receptor assay; non-endocrine (specify receptor)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11720","name":"Debride nail 1-5","description":"Debridement of nail(s) by any method(s); 1 to 5","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27244","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62145","name":"Repair of skull & brain","description":"Cranioplasty for skull defect with reparative brain surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27096","name":"Inject sacroiliac joint","description":"Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or ct) including arthrography when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87560","name":"M.avium-intra dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35458","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55650","name":"Remove sperm duct pouch","description":"Vesiculectomy, any approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25390","name":"Shorten radius or ulna","description":"Osteoplasty, radius or ulna; shortening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45190","name":"Destruction rectal tumor","description":"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5610.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7042","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85246","name":"Clot factor viii vw antigen","description":"Clotting; factor viii, vw factor antigen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27818","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66625","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15297.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27613","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27045","name":"Exc hip/pelv tum deep 5 cm/>","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93544","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32488","name":"Completion pneumonectomy","description":"Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87187","name":"Sc std microdil/agar mlc","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (mlc), each plate (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33212","name":"Insert pulse gen sngl lead","description":"Insertion of pacemaker pulse generator only; with existing single lead","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68810","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65436","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with application of chelating agent (eg, edta)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24495","name":"Decompression fasct forearm","description":"Decompression fasciotomy, forearm, with brachial artery exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1991.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0641","name":"Multi-position stnd fram sys","description":"Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20100","name":"Expl pentrg wound neck","description":"Exploration of penetrating wound (separate procedure); neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0274T","name":"Prq lamot/lam dcmpr crv/thrc","description":"Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, ct), single or multiple levels, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33985","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97533","name":"Sensory integration","description":"Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63101","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55000","name":"Drainage of hydrocele","description":"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15772","name":"Grfg autol fat lipo ea addl","description":"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35459","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62000","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; simple, extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13131","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54352","name":"Revj prior hypspad repair","description":"Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1146.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96567","name":"Pdt dstr prmlg les skn","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44625","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51101","name":"Drain bladder by trocar/cath","description":"Aspiration of bladder; by trocar or intracatheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10007","name":"Fna bx w/fluor gdn 1st les","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67924","name":"Repair eyelid defect","description":"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3252","name":"Shoe molded plastazote cust","description":"Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3604.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44366","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27332","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial or lateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20680","name":"Removal of implant deep","description":"Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84235","name":"Assay of endocrine hormone","description":"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87810","name":"Chlmyd trach assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; chlamydia trachomatis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69706","name":"Nps surg dilat eust tube bi","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32674","name":"Thoracoscopy lymph node exc","description":"Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92002","name":"Intrm oph exam new patient","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2003","name":"Post-d/c h vst new pt 45 m","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55875","name":"Transperi needle place pros","description":"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75954","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3412.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6006","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19284","name":"Perq dev breast add strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37217","name":"Stent placemt retro carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86200","name":"Ccp antibody","description":"Cyclic citrullinated peptide (ccp), antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63307","name":"Remov vert idrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54650","name":"Orchiopexy (fowler-stephens)","description":"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler-stephens)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27258","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11920","name":"Correct skin color 6.0 cm/<","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27330","name":"Biopsy knee joint lining","description":"Arthrotomy, knee; with synovial biopsy only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53448","name":"Remov/replc ur sphinctr comp","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of infected tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30120","name":"Revision of nose","description":"Excision or surgical planing of skin of nose for rhinophyma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37182","name":"Insert hepatic shunt (tips)","description":"Insertion of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95027","name":"Iq tsts seql&incrl airborne","description":"Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58976","name":"Transfer of embryo","description":"Gamete, zygote, or embryo intrafallopian transfer, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69725","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; including medial to geniculate ganglion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4006","name":"Cast sup long arm adult fbrg","description":"Cast supplies, long arm cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29905","name":"Subtalar arthro w/exc","description":"Arthroscopy, subtalar joint, surgical; with synovectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4305","name":"Drug delivery system >=50 ml","description":"Disposable drug delivery system, flow rate of 50 ml or greater per hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28210","name":"Repair/graft of foot tendon","description":"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0146T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["KM","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61610","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21453","name":"Cltx mndblr fx ntrdntl fixj","description":"Closed treatment of mandibular fracture with interdental fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11440","name":"Exc face-mm b9+marg 0.5 cm/<","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95971","name":"Alys smpl sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63047","name":"Lam facetec & foramot lumbar","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27197","name":"Clsd tx pelvic ring fx","description":"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; without","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86510","name":"Histoplasmosis skin test","description":"Skin test; histoplasmosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33925","name":"Rpr pul art unifocal w/o cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21348","name":"Opn tx nasomax fx w/graft","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with bone grafting (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35092","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28280","name":"Fusion of toes","description":"Syndactylization, toes (eg, webbing or kelikian type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26842","name":"Thumb fusion with graft","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36598","name":"Inj w/fluor eval cv device","description":"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43772","name":"Lap rmvl gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1946.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83695","name":"Assay of lipoprotein(a)","description":"Lipoprotein (a)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0523T","name":"Ntrapx c ffr w/3d funcjl map","description":"Intraprocedural coronary fractional flow reserve (ffr) with 3d functional mapping of color-coded ffr values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (list separately in addition to code ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43635","name":"Removal of stomach partial","description":"Vagotomy when performed with partial distal gastrectomy (list separately in addition to code[s] for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83704","name":"Lipoprotein bld quan part","description":"Lipoprotein, blood; quantitation of lipoprotein particle number(s) (eg, by nuclear magnetic resonance spectroscopy), includes lipoprotein particle subclass(es), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519T","name":"Rmv&rplcmt pg wcs lv both","description":"Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; both components (battery and transmitter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85380","name":"Fibrin degradj d-dimer","description":"Fibrin degradation products, d-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33257","name":"Ablate atria lmtd add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27170","name":"Repair/graft femur head/neck","description":"Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20930","name":"Sp bone algrft morsel add-on","description":"Allograft, morselized, or placement of osteopromotive material, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83582","name":"Assay of ketogenic steroids","description":"Ketogenic steroids, fractionation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51050","name":"Removal of bladder stone","description":"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36226","name":"Place cath vertebral art","description":"Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1604.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84540","name":"Assay of urine/urea-n","description":"Urea nitrogen, urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0423","name":"Intens cardiac rehab no exer","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3214","name":"Benesch boot pair junior","description":"Benesch boot, pair, junior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33617","name":"Repair single ventricle","description":"Repair of complex cardiac anomalies (eg, single ventricle) by modified fontan procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1881.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87320","name":"Chlmyd trach ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; chlamydia trachomatis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96910","name":"Photchmtx tar&uvb/ptrltm&uvb","description":"Photochemotherapy; tar and ultraviolet b (goeckerman treatment) or petrolatum and ultraviolet b","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38221","name":"Dx bone marrow biopsies","description":"Diagnostic bone marrow; biopsy(ies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26060","name":"Incision of finger tendon","description":"Tenotomy, percutaneous, single, each digit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82042","name":"Other source albumin quan ea","description":"Albumin; other source, quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50065","name":"Nl sec surg operj calculus","description":"Nephrolithotomy; secondary surgical operation for calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0393","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64744","name":"Incise nerve back of head","description":"Transection or avulsion of; greater occipital nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68840","name":"Explore/irrigate tear ducts","description":"Probing of lacrimal canaliculi, with or without irrigation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33702","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33741","name":"Tas congenital car anomal","description":"Transcatheter atrial septostomy (tas) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, rashkind, sang-park, balloon, cutting balloon, blade)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37619","name":"Ligation of inf vena cava","description":"Ligation of inferior vena cava","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41113","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; posterior one-third","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29868","name":"Meniscal trnspl knee w/scpe","description":"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15839","name":"Exc excessive skn other area","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97813","name":"Acup 1/> w/estim 1st 15 min","description":"Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11601","name":"Exc tr-ext mal+marg 0.6-1 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88321","name":"Consltj&reprt sld prep elswr","description":"Consultation and report on referred slides prepared elsewhere","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82930","name":"Gastric analy w/ph ea spec","description":"Gastric acid analysis, includes ph if performed, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28270","name":"Release of foot contracture","description":"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99336","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92226","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95717","name":"Eeg phys/qhp 2-12 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of eeg recording; without video","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11138.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4298.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33286","name":"Rmvl subq car rhythm mntr","description":"Removal, subcutaneous cardiac rhythm monitor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38305","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; extensive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35231","name":"Repair blvsl vn grf neck","description":"Repair blood vessel with vein graft; neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27740","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44213","name":"Lap mobil splenic fl add-on","description":"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50750","name":"Fusion of ureter & kidney","description":"Ureterocalycostomy, anastomosis of ureter to renal calyx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97755","name":"Assistive technology assess","description":"Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61315","name":"Crnec/crnot ittl ntracereblr","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64911","name":"Neurorraphy w/vein autograft","description":"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86833","name":"Hla class ii high defin qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), hla class ii","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78351","name":"Bone mineral dual photon","description":"Bone density (bone mineral content) study, 1 or more sites; dual photon absorptiometry, 1 or more sites","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91052","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52214","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33710","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64555","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45381","name":"Colonoscopy submucous njx","description":"Colonoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43259","name":"Egd us exam duodenum/jejunum","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54420","name":"Revision of penis","description":"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2416.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1667.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49446","name":"Change g-tube to g-j perc","description":"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"81188","name":"Cstb gene detc abnor allele","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15221","name":"Fth/gft fr s/a/l each addl","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25670","name":"Optx rdcrpl/ntrcrpl dislc 1+","description":"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52318","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65210","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87637","name":"Sarscov2&inf a&b&rsv amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), influenza virus types a and b, and respiratory syncytial virus, multiplex amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58600","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88283","name":"Chromosome banding study","description":"Chromosome analysis; additional specialized banding technique (eg, nor, c-banding)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90913","name":"Bfb training ea addl 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25800","name":"Arthrd wrist complete wo grf","description":"Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28306","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96113","name":"Devel tst phys/qhp ea addl","description":"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80410","name":"Calcitonin stimul panel","description":"Calcitonin stimulation panel (eg, calcium, pentagastrin) this panel must include the following: calcitonin (82308 x 3)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31660","name":"Bronch thermoplsty 1 lobe","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3603.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43274","name":"Ercp duct stent placement","description":"Endoscopic retrograde cholangiopancreatography (ercp); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2599","name":"Sgd accessory noc","description":"Accessory for speech generating device, not otherwise classified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0460","name":"Autolog prp not diab ulcer","description":"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2133.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61340","name":"Subtemporal cranial dcmprn","description":"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5800.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26437","name":"Realignment of tendons","description":"Realignment of extensor tendon, hand, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81329","name":"Smn1 gene dos/deletion alys","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes smn2 (survival of motor neuron 2, centromeric) analysis, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28470","name":"Cltx metatarsal fx wo mnp ea","description":"Closed treatment of metatarsal fracture; without manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32560","name":"Treat pleurodesis w/agent","description":"Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent or persistent pneumothorax)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23620","name":"Cltx gr hmrl tbrs fx wo mnpj","description":"Closed treatment of greater humeral tuberosity fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2180.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64617","name":"Chemodener muscle larynx emg","description":"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66983","name":"Cataract surg w/iol 1 stage","description":"Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87425","name":"Rotavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; rotavirus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26775","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69605","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24545","name":"Optx hum fx wo ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62321","name":"Njx interlaminar crv/thrc","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy o","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26785","name":"Treat finger dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0447T","name":"Rmvl impltbl glucose sensor","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83020","name":"Hemoglobin electrophoresis","description":"Hemoglobin fractionation and quantitation; electrophoresis (eg, a2, s, c, and/or f)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54405","name":"Insert multi-comp penis pros","description":"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17274","name":"Dstr mal les s/n/h/f/g 3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21502","name":"I&d dp abs/hmtm nck rib ostc","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; with partial rib ostectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50280","name":"Exc/unroofing cyst kidney","description":"Excision or unroofing of cyst(s) of kidney","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31561","name":"Larynscop remve cart + scop","description":"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27702","name":"Reconstruct ankle joint","description":"Arthroplasty, ankle; with implant (total ankle)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96132","name":"Nrpsyc tst eval phys/qhp 1st","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the pati","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50392","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3960.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93271","name":"Ecg/monitoring and analysis","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; transmission and analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62326","name":"Njx interlaminar lmbr/sac","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33767","name":"Shunt supr v/c p-art bth lng","description":"Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional glenn procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00740","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0171T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52649","name":"Prostate laser enucleation","description":"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45345","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; recording (includes hook-up, reinforced education, data transmission, data capture, trend analysis, and periodic recalibration)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G9978","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and strai","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27750","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92613","name":"Endoscopy swallow (fees) i&r","description":"Flexible endoscopic evaluation of swallowing by cine or video recording; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10028.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9985","name":"Remote e/m est. pt 25mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a detailed history;  a detailed exam","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32550","name":"Insert pleural cath","description":"Insertion of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84203","name":"Test rbc protoporphyrin","description":"Protoporphyrin, rbc; screen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87537","name":"Hiv-2 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36818","name":"Av fuse uppr arm cephalic","description":"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87552","name":"Mycobacteria dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75685","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33256","name":"Ablate atria w/bypass exten","description":"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25375","name":"Revise radius & ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius and ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29440","name":"Adding walker to prev cast","description":"Adding walker to previously applied cast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26992","name":"Drainage of bone lesion","description":"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92591","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69220","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23076","name":"Exc shoulder tum deep < 5 cm","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61323","name":"Crnec/crnot dcmprv w/lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43770","name":"Lap place gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0540T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45391","name":"Colonoscopy w/endoscope us","description":"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU","AV"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3272.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33963","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59121","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91306","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44365","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87798","name":"Detect agent nos dna amp","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; amplified probe technique, each organism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44393","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8311.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82652","name":"Vit d 1 25-dihydroxy","description":"Vitamin d; 1, 25 dihydroxy, includes fraction(s), if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58573","name":"Tlh w/t/o uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35686","name":"Bypass graft/av fist patency","description":"Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-hemodialysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15135","name":"Drm agrft f/s/n/h/f/g/m 1st","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55831","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82157","name":"Assay of androstenedione","description":"Androstenedione","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83020","name":"Hemoglobin electrophoresis","description":"Hemoglobin fractionation and quantitation; electrophoresis (eg, a2, s, c, and/or f)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27556","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentation/reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8686","name":"Implt nrostm pls gen sng non","description":"Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4064.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83664","name":"Lamellar bdy fetal lung","description":"Fetal lung maturity assessment; lamellar body density","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85175","name":"Blood clot lysis time","description":"Clot lysis time, whole blood dilution","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90801","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21181","name":"Rcnst cntrg b9 tum crnl xtrc","description":"Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0276","name":"Pild/placebo control clin tr","description":"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28060","name":"Partial removal foot fascia","description":"Fasciectomy, plantar fascia; partial (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64901","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; single strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42100","name":"Biopsy roof of mouth","description":"Biopsy of palate, uvula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31725","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19126","name":"Excision addl breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49616","name":"Rpr aa hrn rcr 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3174.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28002","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38305","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; extensive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52290","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33229","name":"Remv&replc pm gen mult leads","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49540","name":"Repair lumbar hernia","description":"Repair lumbar hernia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93565","name":"Njx car cth slctv lv/la ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28825","name":"Partial amputation of toe","description":"Amputation, toe; interphalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"60540","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61539","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35021","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64721","name":"Carpal tunnel surgery","description":"Neuroplasty and/or transposition; median nerve at carpal tunnel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48102","name":"Needle biopsy pancreas","description":"Biopsy of pancreas, percutaneous needle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50392","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27360","name":"Partial removal leg bone(s)","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87400","name":"Influenza a/b each ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; influenza, a or b, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A9538","name":"Tc99m pyrophosphate","description":"Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53020","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); except infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51600","name":"Injection for bladder x-ray","description":"Injection procedure for cystography or voiding urethrocystography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2010","name":"Remot image submit by pt","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m ser","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0110T","name":"Nos quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using other stimuli to assess sensation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4088","name":"Gastro/jejuno tube, low-pro","description":"Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95125","name":"Immunotherapy 2/> injections","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 or more injections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24940","name":"Revision of upper arm","description":"Cineplasty, upper extremity, complete procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62369","name":"Anal sp inf pmp w/reprg&fill","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61108","name":"Tdh pnxr evac&/drg sdrl hmta","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77406","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3651","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42320","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary, external","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44604","name":"Suture large intestine","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64615","name":"Chemodenerv musc migraine","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43881","name":"Impl/rplcmt gstr nstim eltrd","description":"Implantation or replacement of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58605","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30560","name":"Lysis intranasal synechia","description":"Lysis intranasal synechia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33697","name":"Compl rpr tof w/pulm atresia","description":"Complete repair tetralogy of fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81180","name":"Atxn3 gene detc abnor allele","description":"Atxn3 (ataxin 3) (eg, spinocerebellar ataxia, machado-joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4607.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36571","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36469","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21143","name":"Rcnstj mdface lefort i 3/>pc","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, without bone graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21339","name":"Open nasoethmoid fx w/ fixj","description":"Open treatment of nasoethmoid fracture; with external fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81312","name":"Pabpn1 gene detc abnor allel","description":"Pabpn1 (poly[a] binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5469.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63306","name":"Remov vert idrl bdy thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4149","name":"Ef blenderized foods","description":"Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61026","name":"Injection into brain canal","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27110","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to greater trochanter of femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82379","name":"Assay of carnitine","description":"Carnitine (total and free), quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35111","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, splenic artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86079","name":"Phys blood bank serv authrj","description":"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of rh incompatible units), with written report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93544","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21356","name":"Opn tx dprsd zygomatic arch","description":"Open treatment of depressed zygomatic arch fracture (eg, gillies approach)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33206","name":"Insert heart pm atrial","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50976","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63610","name":"Stimulation of spinal cord","description":"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31529","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29826","name":"Sho arthrs srg decompression","description":"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78594","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83516","name":"Immunoassay nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28505","name":"Treat big toe fracture","description":"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75992","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47100","name":"Wedge biopsy of liver","description":"Biopsy of liver, wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00634","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44700","name":"Suspend bowel w/prosthesis","description":"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23125","name":"Claviculectomy total","description":"Claviculectomy; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31825","name":"Repair of windpipe defect","description":"Surgical closure tracheostomy or fistula; with plastic repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C1300","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4222","name":"Parenteral supply kit homemi","description":"Parenteral nutrition supply kit; home mix, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52352","name":"Cystouretero w/stone remove","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14040","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69840","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21340","name":"Perq tx nasoethmoid fx","description":"Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58210","name":"Extensive hysterectomy","description":"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26118","name":"Rad resect hand tumor 3 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"45121","name":"Removal of rectum and colon","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0412","name":"Open tx iliac spine uni/bil","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11442","name":"Exc face-mm b9+marg 1.1-2 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24802","name":"Arthrd elbow jt autog graft","description":"Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93545","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3005.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50705","name":"Ureteral embolization/occl","description":"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"52346","name":"Cystouretero w/renal strict","description":"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81311","name":"Nras gene variants exon 2&3","description":"Nras (neuroblastoma ras viral [v-ras] oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88142","name":"Cytopath c/v thin layer","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91105","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50548","name":"Laparo remove w/ureter","description":"Laparoscopy, surgical; nephrectomy with total ureterectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99325","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53270","name":"Removal of urethra gland","description":"Excision or fulguration; skenes glands","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87503","name":"Influenza dna amp prob addl","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, each additional influenza virus type or sub-type beyond 2 (list separately in addition to code","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82805","name":"Blood gases w/o2 saturation","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation); with o2 saturation, by direct measurement, except pulse oximetry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24635","name":"Optx monteggia fx dislc elbw","description":"Open treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0637","name":"Combination sit to stand sys","description":"Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85397","name":"Clotting funct activity","description":"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, adamts-13), each analyte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21011","name":"Exc face les sc <2 cm","description":"Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83615","name":"Lactate (ld) (ldh) enzyme","description":"Lactate dehydrogenase (ld), (ldh);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"11005","name":"Dbrdmt skin abdominal wall","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4223","name":"Infusion supplies w/o pump","description":"Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2158.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27457","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47785","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of intrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64890","name":"Nrv grf 1strnd hnd/foot <4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60270","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21452","name":"Perq tx mndblr fx xtrnl fixj","description":"Percutaneous treatment of mandibular fracture, with external fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0307","name":"Cbc without platelet","description":"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0310","name":"Immunize counsel 5-15 min","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33203","name":"Insert epicard eltrd endo","description":"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26785","name":"Treat finger dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"61522","name":"Removal of brain abscess","description":"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28190","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; subcutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4162","name":"Ef ped specmetabolic inherit","description":"Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33202","name":"Insert epicard eltrd open","description":"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3745.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25431","name":"Repair nonunion carpal bone","description":"Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96130","name":"Psycl tst eval phys/qhp 1st","description":"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27602","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88235","name":"Tissue culture placenta","description":"Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77522","name":"Proton trmt simple w/comp","description":"Proton treatment delivery; simple, with compensation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22514","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21395","name":"Opn tx orbit periorbt w/grft","description":"Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80164","name":"Assay dipropylacetic acd tot","description":"Valproic acid (dipropylacetic acid); total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88174","name":"Cytopath c/v auto in fluid","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29800","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28666","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2400.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92316","name":"C-lens fitg tech aphakia ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87900","name":"Phenotype infect agent drug","description":"Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9275","name":"Disp home glucose monitor","description":"Home glucose disposable monitor, includes test strips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61517","name":"Implt brn intrcv chemotx agt","description":"Implantation of brain intracavitary chemotherapy agent (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33214","name":"Upgrade of pacemaker system","description":"Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64600","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87389","name":"Hiv-1 ag w/hiv-1&-2 ab ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1 antigen(s), with hiv-1 and hiv-2 antibodies, single resu","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58950","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64573","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95722","name":"Eeg phy/qhp>36<60 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of eeg recording, with video (veeg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87902","name":"Nfct agt gntyp alys hep c","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis c virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23405","name":"Incision of tendon & muscle","description":"Tenotomy, shoulder area; single tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90817","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58280","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43847","name":"Gstr rstcv px sm int rcnstj","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87634","name":"Rsv dna/rna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory syncytial virus, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0476","name":"Hpv combo assay ca screen","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29590","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20956","name":"Iliac bone graft microvasc","description":"Bone graft with microvascular anastomosis; iliac crest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35601","name":"Bpg com crtd-ipsi int crtd","description":"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1768","name":"Graft, vascular","description":"Graft, vascular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32491","name":"Lung volume reduction","description":"Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21208","name":"Augmentation of facial bones","description":"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0108T","name":"Cool quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using cooling stimuli to assess small nerve fiber sensation and hyperalgesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99426","name":"Prin care mgmt staff 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31528","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99224","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43520","name":"Incision of pyloric muscle","description":"Pyloromyotomy, cutting of pyloric muscle (fredet-ramstedt type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87476","name":"Lyme dis dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25135","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","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":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87500","name":"Vanomycin dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); vancomycin resistance (eg, enterococcus species van a, van b), amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21365","name":"Opn tx complx malar fx","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11310","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21440","name":"Cltx mndblr/max alv ridge fx","description":"Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97033","name":"App mdlty 1+iontphrsis ea 15","description":"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25312","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54130","name":"Remove penis & nodes","description":"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20527","name":"Njx nzm palmar fascial cord","description":"Injection, enzyme (eg, collagenase), palmar fascial cord (ie, dupuytrens contracture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"T4536","name":"Reusable pull-on any size","description":"Incontinence product, protective underwear/pull-on, reusable, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46288","name":"Repair anal fistula","description":"Closure of anal fistula with rectal advancement flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20982","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61558","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43267","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45355","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4929","name":"Tourniquet for dialysis, ea","description":"Tourniquet for dialysis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57267","name":"Insert mesh/pelvic flr addon","description":"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66250","name":"Follow-up surgery of eye","description":"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96933","name":"Rcm i&r only 1st lesion","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; interpretation and report only, first lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69670","name":"Remove mastoid air cells","description":"Mastoid obliteration (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34846","name":"Visc & infraren abd 2 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54860","name":"Removal of epididymis","description":"Epididymectomy; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64493","name":"Inj paravert f jnt l/s 1 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; single level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4213","name":"20+ cc syringe only","description":"Syringe, sterile, 20 cc or greater, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12042","name":"Intmd rpr n-hf/genit2.6-7.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3461.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24666","name":"Optx radial head/nck fx rplc","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64822","name":"Sympathectomy ulnar artery","description":"Sympathectomy; ulnar artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24685","name":"Optx ulnar fx prox end w/fix","description":"Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4932","name":"Reusable rectal thermometer","description":"Rectal thermometer, reusable, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1976.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99458","name":"Rpm tx mgmt ea addl 20 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62324","name":"Njx interlaminar crv/thrc","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thorac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10697.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76496","name":"Unlisted fluoroscopic px","description":"Unlisted fluoroscopic procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47370","name":"Laparo ablate liver tumor rf","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43112","name":"Esphg tot w/thrcm","description":"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, mckeown esophagectomy or tri-incisional esophagectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3137.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33978","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64616","name":"Chemodenerv musc neck dyston","description":"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64517","name":"N block inj hypogas plxs","description":"Injection, anesthetic agent; superior hypogastric plexus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45111","name":"Partial removal of rectum","description":"Proctectomy; partial resection of rectum, transabdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43100","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; cervical approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35903","name":"Excision graft extremity","description":"Excision of infected graft; extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31201","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21935","name":"Resect back tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2215.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27613","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2492.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25248","name":"Remove forearm foreign body","description":"Exploration with removal of deep foreign body, forearm or wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67971","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83896","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47900","name":"Suture bile duct injury","description":"Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64400","name":"Njx aa&/strd trigeminal nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43846","name":"Gstr rstcv px shrt roux-en-y","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) roux-en-y gastroenterostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46750","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; adult","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1800","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4082","name":"Enteral ng tubing w/o stylet","description":"Nasogastric tubing without stylet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0422","name":"Intens cardiac rehab w/exerc","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26489","name":"Transplant/graft palm tendon","description":"Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69801","name":"Incise inner ear","description":"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20664","name":"Appl halo cranial 6+pins","description":"Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33391","name":"Valvuloplasty aortic valve","description":"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33422","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; open heart, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40840","name":"Reconstruction of mouth","description":"Vestibuloplasty; anterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E8000","name":"Posterior gait trainer","description":"Gait trainer, pediatric size, posterior support, includes all accessories and components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55300","name":"Prepare sperm duct x-ray","description":"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68540","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; frontal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2054.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33282","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546T","name":"Rf spectrsc ntraop mrgn asmt","description":"Radiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63707","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1788.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29058","name":"Appl cast plaster velpeau","description":"Application, cast; plaster velpeau","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96365","name":"Ther/proph/diag iv inf init","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65781","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46910","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42215","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; major revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1800","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0107T","name":"Vibrate quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using vibration stimuli to assess large diameter fiber sensation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0246","name":"Followup eval of foot pt lop","description":"Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21155","name":"Rcnstj mdfc lefort iii w/i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3253","name":"Shoe molded plastazote cust","description":"Foot, molded shoe plastazote (or similar) custom fitted, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4663","name":"Dialysis blood pressure cuff","description":"Blood pressure cuff only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31648","name":"Bronchial valve remov init","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43282","name":"Lap paraesoph her rpr w/mesh","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32408","name":"Core ndl bx lng/med perq","description":"Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25450","name":"Epiphysl arrst dstl rds/ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius or ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3332.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27057","name":"Buttock fasciotomy w/dbrdmt","description":"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) with debridement of nonviable muscle, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36140","name":"Intro ndl icath upr/lxtr art","description":"Introduction of needle or intracatheter, upper or lower extremity artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59051","name":"Fetal monitor/interpret only","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65756","name":"Corneal trnspl endothelial","description":"Keratoplasty (corneal transplant); endothelial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65426","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; with graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96112","name":"Devel tst phys/qhp 1st hr","description":"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3735.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28715.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93015","name":"Cv stress test supvj i&r","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30450","name":"Revision of nose","description":"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31715","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47142","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments v, vi, vii and viii)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3968.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44380","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64859","name":"Nerve surgery","description":"Suture of each additional major peripheral nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41005","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24075","name":"Exc arm/elbow les sc < 3 cm","description":"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3794.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22513","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"60212","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27228","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes t-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1594.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44127","name":"Enterectomy w/taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15731","name":"Forehead flap w/vasc pedicle","description":"Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88262","name":"Chromosome analysis 15-20","description":"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15952","name":"Exc trchntr pr ulc flp clsr","description":"Excision, trochanteric pressure ulcer, with skin flap closure;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99448","name":"Ntrprof ph1/ntrnet/ehr 21-30","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45339","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5010","name":"Assessment for hearing aid","description":"Assessment for hearing aid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8687","name":"Implt nrostm pls gen dua rec","description":"Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33974","name":"Remove intra-aortic balloon","description":"Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82397","name":"Chemiluminescent assay","description":"Chemiluminescent assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81234","name":"Dmpk gene detc abnor allele","description":"Dmpk (dm1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50385","name":"Change stent via transureth","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87525","name":"Hepatitis g dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36225","name":"Place cath subclavian art","description":"Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95145","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81183","name":"Atxn10 gene detc abnor allel","description":"Atxn10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25023","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64772","name":"Incision of spinal nerve","description":"Transection or avulsion of other spinal nerve, extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2012","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43232","name":"Esophagoscopy w/us needle bx","description":"Esophagoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27254","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32150","name":"Removal of lung lesion(s)","description":"Thoracotomy; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4252","name":"Blood ketone test or strip","description":"Blood ketone test or reagent strip, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21076","name":"Impres&prep surg obt prosth","description":"Impression and custom preparation; surgical obturator prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"M0243","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88235","name":"Tissue culture placenta","description":"Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64634","name":"Destroy c/th facet jnt addl","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, each additional facet joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4199","name":"Parenteral sol > 100gm prote","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92004","name":"Compre oph exam new pt 1/>","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46606","name":"Anoscopy and biopsy","description":"Anoscopy; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":979.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50728","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2416.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40804","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21193","name":"Reconst lwr jaw w/o graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; without bone graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440T","name":"Abltj perc uxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4997.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43276","name":"Ercp stent exchange w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98942","name":"Chiropractic manj 5 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 5 regions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55300","name":"Prepare sperm duct x-ray","description":"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49323","name":"Laparo drain lymphocele","description":"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86808","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); quick method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80200","name":"Assay of tobramycin","description":"Tobramycin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49507","name":"Prp i/hern init block >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6025","name":"Silicone gel sheet, each","description":"Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21188","name":"Reconstruction of midface","description":"Reconstruction midface, osteotomies (other than lefort type) and bone grafts (includes obtaining autografts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27405","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; collateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27499","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2861","name":"Torsion mechanism knee/ankle","description":"Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47539","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35452","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21296","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9552","name":"F18 fdg","description":"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26686","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50576","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81320","name":"Plcg2 gene common variants","description":"Plcg2 (phospholipase c gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, r665w, s707f, l845f)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23900","name":"Interthoracoscplr amputation","description":"Interthoracoscapular amputation (forequarter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82541","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80160","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64624","name":"Dstrj nulyt agt gnclr nrv","description":"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24126","name":"Exc/crtg b1 cst/tum rds algr","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47534","name":"Plmt biliary drainage cath","description":"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0081","name":"Care man h v ext pt 20 mi","description":"Brief (20 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49412","name":"Ins device for rt guide open","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed, single or multiple (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27540","name":"Treat knee fracture","description":"Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57109","name":"Vagnc bi total pel lymphadec","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58662","name":"Laparoscopy excise lesions","description":"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34847","name":"Visc & infraren abd 3 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46712","name":"Repr per/vag pouch dbl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62220","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-atrial, -jugular, -auricular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23040","name":"Arthrt gh jt expl/drg/rmv fb","description":"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"89125","name":"Specimen fat stain","description":"Fat stain, feces, urine, or respiratory secretions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44157","name":"Colectomy w/ileoanal anast","description":"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop ileostomy, and rectal mucosectomy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1630.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61522","name":"Removal of brain abscess","description":"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"41005","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82387","name":"Assay of cathepsin-d","description":"Cathepsin-d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58340","name":"Catheter for hysterography","description":"Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35306","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30410","name":"Reconstruction of nose","description":"Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84061","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42842","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90823","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44900","name":"I&d appendix abscess open","description":"Incision and drainage of appendiceal abscess, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83858","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99417","name":"Prolng op e/m each 15 min","description":"Prolonged outpatient evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the code of the outpa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90816","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46748","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36908","name":"Stent plmt ctr dialysis seg","description":"Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (list separately in addition to","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86806","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; without titration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15340","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3960.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86735","name":"Mumps antibody","description":"Antibody; mumps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"Per pm reeval est pat 65+ yr","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 ye","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69805","name":"Explore inner ear","description":"Endolymphatic sac operation; without shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33401","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25526","name":"Optx rdl shft fx&dstl rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83993","name":"Assay for calprotectin fecal","description":"Calprotectin, fecal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93316","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35001","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31390","name":"Removal of larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; without reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26706","name":"Pin knuckle dislocation","description":"Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86689","name":"Htlv/hiv confirmj antibody","description":"Antibody; htlv or hiv antibody, confirmatory test (eg, western blot)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33516","name":"Cabg vein six or more","description":"Coronary artery bypass, vein only; 6 or more coronary venous grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36474","name":"Endovenous mchnchem add-on","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54344","name":"Rrp hypspad comp moblj&urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27825","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54057","name":"Laser surg penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4813.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21040","name":"Excise mandible lesion","description":"Excision of benign tumor or cyst of mandible, by enucleation and/or curettage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82742","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52285","name":"Cystoscopy and treatment","description":"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43260","name":"Ercp w/specimen collection","description":"Endoscopic retrograde cholangiopancreatography (ercp); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87531","name":"Hhv-6 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99145","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1166.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33966","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67228","name":"Treatment x10sv retinopathy","description":"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29835","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61120","name":"Burr hole for ventr puncture","description":"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54056","name":"Cryosurgery penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36823","name":"Insertion of cannula(s)","description":"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) and repair of arteriotomy and venotomy sites","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5480.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26478","name":"Lengthening of hand tendon","description":"Lengthening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57320","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; vaginal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63301","name":"Remove vert xdrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25447","name":"Arthrp ntrcrp/crp/mtcr ntrps","description":"Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35638","name":"Bpg aortobi-iliac","description":"Bypass graft, with other than vein; aortobi-iliac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24077","name":"Rad rescj tum tiss a/e <5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96127","name":"Brief emotional/behav assmt","description":"Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [adhd] scale), with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69554","name":"Exc aurl glomus tum extended","description":"Excision aural glomus tumor; extended (extratemporal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60240","name":"Removal of thyroid","description":"Thyroidectomy, total or complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60212","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52240","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17261","name":"Dstrj mal les t/a/l .6-1.0cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92354","name":"Fitg spect low vis 1system","description":"Fitting of spectacle mounted low vision aid; single element system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82488","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53852","name":"Prostatic rf thermotx","description":"Transurethral destruction of prostate tissue; by radiofrequency thermotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87277","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67550","name":"Insert eye socket implant","description":"Orbital implant (implant outside muscle cone); insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27339","name":"Exc thigh/knee tum dep 5cm/>","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86337","name":"Insulin antibodies","description":"Insulin antibodies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58110","name":"Bx done w/colposcopy add-on","description":"Endometrial sampling (biopsy) performed in conjunction with colposcopy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61563","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22867","name":"Insj stablj dev w/dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3174.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4673","name":"Ext line w easy lock connect","description":"Extension line with easy lock connectors, used with dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82108","name":"Assay of aluminum","description":"Aluminum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7300.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45345","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35001","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32652","name":"Thoracoscopy rem totl cortex","description":"Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"63600","name":"Remove spinal cord lesion","description":"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0128","name":"Corf skilled nursing service","description":"Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41250","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65785","name":"Impltj ntrstrml crnl rng seg","description":"Implantation of intrastromal corneal ring segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27634","name":"Exc leg/ankle tum dep 5 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88249","name":"Chromosome analysis 100","description":"Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress (eg, diepoxybutane, mitomycin c, ionizing radiation, uv radiation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29907","name":"Subtalar arthro w/fusion","description":"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99374","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59870","name":"Evacuate mole of uterus","description":"Uterine evacuation and curettage for hydatidiform mole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35656","name":"Bpg femoral-popliteal","description":"Bypass graft, with other than vein; femoral-popliteal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81179","name":"Atxn2 gene detc abnor allele","description":"Atxn2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35361","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21337","name":"Closed tx septal&nose fx","description":"Closed treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2572.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35271","name":"Rpr blvs gr ot/th vn ntrth w","description":"Repair blood vessel with graft other than vein; intrathoracic, with bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82252","name":"Fecal bilirubin test","description":"Bilirubin; feces, qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15841","name":"Nerve palsy muscle graft","description":"Graft for facial nerve paralysis; free muscle graft (including obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2590.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35509","name":"Art byp grft contral carotid","description":"Bypass graft, with vein; carotid-contralateral carotid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1449.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"T4523","name":"Adult size brief/diaper lg","description":"Adult sized disposable incontinence product, brief/diaper, large, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0198T","name":"Ocular blood flow measure","description":"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2339.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27078","name":"Rsect hip tum incl femur","description":"Radical resection of tumor; ischial tuberosity and greater trochanter of femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19103","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67040","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27245","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29355","name":"Appl long leg cast walker","description":"Application of long leg cast (thigh to toes); walker or ambulatory type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0249T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5962.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35481","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84134","name":"Assay of prealbumin","description":"Prealbumin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29836","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12045","name":"Intmd rpr n-hf/genit12.6-20","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96158","name":"Hlth bhv ivntj indiv 1st 30","description":"Health behavior intervention, individual, face-to-face; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44206","name":"Lap part colectomy w/stoma","description":"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49326","name":"Lap w/omentopexy add-on","description":"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33992","name":"Rmvl perq left heart vad","description":"Removal of percutaneous left heart ventricular assist device, arterial or arterial and venous cannula(s), at separate and distinct session from insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3673","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1982.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35637","name":"Bpg aortoiliac","description":"Bypass graft, with other than vein; aortoiliac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43197","name":"Esophagoscopy flex dx brush","description":"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21936","name":"Resect back tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6549","name":"Grad com garm noc day use","description":"Gradient compression garment, not otherwise specified, for daytime use, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87471","name":"Bartonella dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20936","name":"Sp bone agrft local add-on","description":"Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3339.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0498","name":"Chemo extend iv infus w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27506","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77409","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33270","name":"Ins/rep subq defibrillator","description":"Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic param","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87265","name":"Pertussis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; bordetella pertussis/parapertussis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99380","name":"Nursing fac care supervision","description":"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, comm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0199","name":"Med abortion inc all ex drug","description":"Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83893","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33880","name":"Evasc rpr ta ndgft cov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft covering the left subclavian artery and all aortic tube endograft e","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22513","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97537","name":"Community/work reintegration","description":"Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92995","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43273","name":"Endoscopic pancreatoscopy","description":"Endoscopic cannulation of papilla with direct visualization of pancreatic/common bile duct(s) (list separately in addition to code(s) for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0075","name":"Transport port x-ray multipl","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63016","name":"Remove spine lamina >2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17272","name":"Dstr mal les s/n/h/f/g 1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93295","name":"Dev interrog remote 1/2/mlt","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61519","name":"Remove brain lining lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0710","name":"Restraints any type","description":"Restraints, any type (body, chest, wrist or ankle)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29906","name":"Subtalar arthro w/deb","description":"Arthroscopy, subtalar joint, surgical; with debridement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49465","name":"Fluoro exam of g/colon tube","description":"Contrast injection(s) for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, from a percutaneous approach including image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99452","name":"Ntrprof ph1/ntrnet/ehr rfrl","description":"Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting physician or other qualified health care professional, 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1938.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33227","name":"Remove&replace pm gen singl","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64856","name":"Repair/transpose nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22634","name":"Arthrd cmbn 1ntrspc ea addl","description":"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for prima","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98981","name":"Rtm tx mgmt ea addl 20 min","description":"Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least 1 real-time interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83902","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84112","name":"Eval amniotic fluid protein","description":"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [pamg-1], placental protein 12 [pp12], alpha-fetoprotein), qualitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35321","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; axillary-brachial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0092","name":"Set up port xray equipment","description":"Set-up portable x-ray equipment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"19380","name":"Revj reconstructed breast","description":"Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88166","name":"Cytopath tbs c/v auto redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92004","name":"Compre oph exam new pt 1/>","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31781","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervicothoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15952","name":"Exc trchntr pr ulc flp clsr","description":"Excision, trochanteric pressure ulcer, with skin flap closure;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19367","name":"Brst rcnstj 1 pdcl tram flap","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87205","name":"Smear gram stain","description":"Smear, primary source with interpretation; gram or giemsa stain for bacteria, fungi, or cell types","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89100","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58291","name":"Vag hyst incl t/o complex","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59525","name":"Remove uterus after cesarean","description":"Subtotal or total hysterectomy after cesarean delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63081","name":"Remove vert body dcmprn crvl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96360","name":"Hydration iv infusion init","description":"Intravenous infusion, hydration; initial, 31 minutes to 1 hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86651","name":"Encephalitis californ antbdy","description":"Antibody; encephalitis, california (la crosse)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35700","name":"Reoperation bypass graft","description":"Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33533","name":"Cabg arterial single","description":"Coronary artery bypass, using arterial graft(s); single arterial graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2325.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28090","name":"Removal of foot lesion","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33031","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81344","name":"Tbp gene detc abnor alleles","description":"Tbp (tata box binding protein) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99337","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27187","name":"Reinforce hip bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28575","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41250","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82938","name":"Gastrin test","description":"Gastrin after secretin stimulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32562","name":"Lyse chest fibrin subq day","description":"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequent day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"10035","name":"Plmt sft tiss loclzj dev 1st","description":"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26553","name":"Single transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2772.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53444","name":"Insert tandem cuff","description":"Insertion of tandem cuff (dual cuff)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24200","name":"Rmvl fb upper arm/elbw subq","description":"Removal of foreign body, upper arm or elbow area; subcutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6025","name":"Silicone gel sheet, each","description":"Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31295","name":"Nsl/sins ndsc surg max sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1407.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5067.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21603","name":"Exc ch wal tum w/lymphadec","description":"Excision of chest wall tumor involving rib(s), with plastic reconstruction; with mediastinal lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35302","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; superficial femoral artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G2014","name":"Post-d/c care plan overs 30m","description":"Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26844","name":"Fusion/graft of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20956","name":"Iliac bone graft microvasc","description":"Bone graft with microvascular anastomosis; iliac crest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2246.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1831.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2537.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"Init pm e/m new pat 65+ yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and old","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80152","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50382","name":"Change ureter stent percut","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4300","name":"Cath impl vasc access portal","description":"Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23921","name":"Disarticulation sho sec clsr","description":"Disarticulation of shoulder; secondary closure or scar revision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9503","name":"Tc99m medronate","description":"Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86922","name":"Compatibility test antiglob","description":"Compatibility test each unit; antiglobulin technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27331","name":"Explore/treat knee joint","description":"Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27222","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88285","name":"Chromosome count additional","description":"Chromosome analysis; additional cells counted, each study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88321","name":"Consltj&reprt sld prep elswr","description":"Consultation and report on referred slides prepared elsewhere","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4524","name":"Adult size brief/diaper xl","description":"Adult sized disposable incontinence product, brief/diaper, extra large, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485T","name":"Oct mid ear i&r unilateral","description":"Optical coherence tomography (oct) of middle ear, with interpretation and report; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27591","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; immediate fitting technique including first cast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53080","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; uncomplicated (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45114","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; abdominal and transsacral approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11404","name":"Exc tr-ext b9+marg 3.1-4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99335","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3817.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37226","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61607","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27524","name":"Treat kneecap fracture","description":"Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"19284","name":"Perq dev breast add strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17260","name":"Dstrj mal les t/a/l 0.5 cm/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15241","name":"Fth/gft f/c/c/m/n/a/g/h/f ea","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23107","name":"Arthrt glenhumrl jt w/expl","description":"Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4648","name":"Implantable tissue marker","description":"Tissue marker, implantable, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27306","name":"Incision of thigh tendon","description":"Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81181","name":"Atxn7 gene detc abnor allele","description":"Atxn7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22810","name":"Arthrd ant dfrm 4-7 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29830","name":"Elbow arthroscopy","description":"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47711","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58673","name":"Laparoscopy salpingostomy","description":"Laparoscopy, surgical; with salpingostomy (salpingoneostomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37232","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61611","name":"Transect artery sinus","description":"Transection or ligation, carotid artery in petrous canal; without repair (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0082","name":"Care man h v ext pt 30 m","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47740","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4263","name":"Permanent tear duct plug","description":"Permanent, long term, non-dissolvable lacrimal duct implant, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76150","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26553","name":"Single transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23460.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27645","name":"Resect tibia tumor","description":"Radical resection of tumor; tibia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36810","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (scribner type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33982","name":"Replace vad intra w/o bp","description":"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11640","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86835","name":"Hla class ii semiquant panel","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); semi-quantitative panel (eg, titer), hla class ii","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99318","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22632","name":"Arthrd pst tq 1ntrspc lm ea","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4532","name":"Ped size pull-on lg","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27301","name":"Drain thigh/knee lesion","description":"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80103","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43458","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25685","name":"Optx trns-scphprlnr fx dislc","description":"Open treatment of trans-scaphoperilunar type of fracture dislocation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83906","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4732.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35180","name":"Rpr cgen av fistula head&nck","description":"Repair, congenital arteriovenous fistula; head and neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38207","name":"Cryopreserve stem cells","description":"Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26390","name":"Revise hand/finger tendon","description":"Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87252","name":"Virus inoculation tissue","description":"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92973","name":"Prq trluml c mchn asp thrmbc","description":"Percutaneous transluminal coronary mechanical aspiration thrombectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93299","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3438.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21451","name":"Cltx mndblr fx w/mnpj","description":"Closed treatment of mandibular fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34970.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33776","name":"Rpr tga atr bfl clsr vsd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with closure of ventricular septal defect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28308","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69300","name":"Revise external ear","description":"Otoplasty, protruding ear, with or without size reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81329","name":"Smn1 gene dos/deletion alys","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg, carrier testing), includes smn2 (survival of motor neuron 2, centromeric) analysis, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64836","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; ulnar motor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77372","name":"Srs linear based","description":"Radiation treatment delivery, stereotactic radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25820","name":"Arthrd wrist lmtd w/o b1 grf","description":"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62120","name":"Repair skull cavity lesion","description":"Repair of encephalocele, skull vault, including cranioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"69661","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83909","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80438","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 1 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 3)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23450","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; putti-platt procedure or magnuson type operation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96146","name":"Psycl/nrpsyc tst auto result","description":"Psychological or neuropsychological test administration, with single automated, standardized instrument via electronic platform, with automated result only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25907","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; secondary closure or scar revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83937","name":"Assay of osteocalcin","description":"Osteocalcin (bone g1a protein)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8387.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43220","name":"Esophagoscopy balloon <30mm","description":"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95081.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25431","name":"Repair nonunion carpal bone","description":"Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23410","name":"Repair rotator cuff acute","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63194","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4565.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31040","name":"Exploration behind upper jaw","description":"Pterygomaxillary fossa surgery, any approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27307","name":"Incision of thigh tendons","description":"Tenotomy, percutaneous, adductor or hamstring; multiple tendons","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61332","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63091","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32504","name":"Resect apical lung tum/chest","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67227","name":"Dstrj extensive retinopathy","description":"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67320","name":"Revise eye muscle(s) add-on","description":"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27151","name":"Incision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87541","name":"Legion pneumo dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43201","name":"Esoph scope w/submucous inj","description":"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17314","name":"Mohs addl stage t/a/l","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), o","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35800","name":"Explore neck vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64835","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; median motor thenar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58960","name":"Exploration of abdomen","description":"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92558","name":"Evoked auditory test qual","description":"Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L8010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2634.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33860","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6306.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85306","name":"Clot inhibit prot s free","description":"Clotting inhibitors or anticoagulants; protein s, free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0103","name":"Psa screening","description":"Prostate cancer screening; prostate specific antigen test (psa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90875","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37225","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35879","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21610","name":"Costotransversectomy","description":"Costotransversectomy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32800","name":"Repair lung hernia","description":"Repair lung hernia through chest wall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43332","name":"Transab esoph hiat hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54438","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82690","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21431","name":"Cltx craniofacial separation","description":"Closed treatment of craniofacial separation (lefort iii type) using interdental wire fixation of denture or splint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49423","name":"Exchange drainage catheter","description":"Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92977","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6455.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5646.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91307","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55873","name":"Cryoablate prostate","description":"Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33214","name":"Upgrade of pacemaker system","description":"Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19126","name":"Excision addl breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52500","name":"Trurl resection bladder neck","description":"Transurethral resection of bladder neck (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81183","name":"Atxn10 gene detc abnor allel","description":"Atxn10 (ataxin 10) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84210","name":"Assay of pyruvate","description":"Pyruvate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22586","name":"Arthrd pre-sac ntrbdy l5-s1","description":"Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3203","name":"Oxford w/ supinator/pronator","description":"Orthopedic shoe, oxford with supinator or pronator, junior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30420","name":"Reconstruction of nose","description":"Rhinoplasty, primary; including major septal repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23397","name":"Muscle transfers","description":"Muscle transfer, any type, shoulder or upper arm; multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26518","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 3 or 4 digits","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36253","name":"Ins cath ren art 2nd+ unilat","description":"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, an","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1803.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54600","name":"Reduce testis torsion","description":"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2443.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61642","name":"Dilat ic vspsm ea diff ter","description":"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0433","name":"Elisa hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38900","name":"Io map of sent lymph node","description":"Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92310","name":"Contact lens fitting ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21240","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7836.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87517","name":"Hepatitis b dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93514","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58800","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97004","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0077","name":"Care manag h vst new pt 30 m","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35082","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1923.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22864","name":"Rmvl tot arthrp 1ntrspc crv","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33606","name":"Anastomosis/artery-aorta","description":"Anastomosis of pulmonary artery to aorta (damus-kaye-stansel procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61650","name":"Evasc prlng admn rx agnt 1st","description":"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27070","name":"Part remove hip bone super","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26357","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, without free graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43496","name":"Free jejunum flap microvasc","description":"Free jejunum transfer with microvascular anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86778","name":"Toxoplasma antibody igm","description":"Antibody; toxoplasma, igm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50430","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55706","name":"Bx prst8 ndl sat sampling","description":"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33120","name":"Exc icar tum resc w/card byp","description":"Excision of intracardiac tumor, resection with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33964","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26820","name":"Thumb fusion with graft","description":"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4915.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33234","name":"Removal of pacemaker system","description":"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1809.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43193","name":"Esophagoscp rig trnso biopsy","description":"Esophagoscopy, rigid, transoral; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19295","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31660","name":"Bronch thermoplsty 1 lobe","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0812","name":"Power operated vehicle noc","description":"Power operated vehicle, not otherwise classified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30802","name":"Ablate inf turbinate submuc","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86060","name":"Antistreptolysin o titer","description":"Antistreptolysin 0; titer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0248","name":"Hdtrans bench w/wo comm open","description":"Transfer bench, heavy duty, for tub or toilet with or without commode opening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38212","name":"Rbc depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; red blood cell removal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33521","name":"Cabg artery-vein four","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28436","name":"Prq skel fix talus fx w/mnpj","description":"Percutaneous skeletal fixation of talus fracture, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G2007","name":"Post-d/c h vst ext pt 30 m","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient faci","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45321","name":"Proctosigmoidoscopy volvul","description":"Proctosigmoidoscopy, rigid; with decompression of volvulus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90869","name":"Tcran magn stim redetemine","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent motor threshold re-determination with delivery and management","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64565","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14301","name":"Tis trnfr any 30.1-60 sq cm","description":"Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33477","name":"Implant tcat pulm vlv perq","description":"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25420","name":"Repair/graft radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1717","name":"Brachytx, non-str,hdr ir-192","description":"Brachytherapy source, non-stranded, high dose rate iridium-192, per source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87902","name":"Nfct agt gntyp alys hep c","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis c virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"C1769","name":"Guide wire","description":"Guide wire","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2180.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28890","name":"Hi enrgy eswt plantar fascia","description":"Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45338","name":"Sigmoidoscopy w/tumr remove","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33262","name":"Rmvl& replc pulse gen 1 lead","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49615","name":"Rpr aa hrn rcr 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15824","name":"Rhytidectomy forehead","description":"Rhytidectomy; forehead","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63615","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1748.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92002","name":"Intrm oph exam new patient","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33216","name":"Insert 1 electrode pm-defib","description":"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77435","name":"Sbrt management","description":"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33508","name":"Endoscopic vein harvest","description":"Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90997","name":"Hemoperfusion","description":"Hemoperfusion (eg, with activated charcoal or resin)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80430","name":"Growth hormone panel","description":"Growth hormone suppression panel (glucose administration) this panel must include the following: glucose (82947 x 3) human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27122","name":"Reconstruction of hip socket","description":"Acetabuloplasty; resection, femoral head (eg, girdlestone procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99218","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25630","name":"Cltx carpl fx w/o mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22212","name":"Incis 1 vertebral seg thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46614","name":"Anoscopy control bleeding","description":"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["KM","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49441","name":"Place duod/jej tube perc","description":"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34520","name":"Cross-over vein graft","description":"Cross-over vein graft to venous system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99454","name":"Rem mntr physiol param 16-30","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2451.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95133","name":"Immntx 4 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 4 stinging insect venoms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43456","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62368","name":"Analyze sp inf pump w/reprog","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28046","name":"Resect foot/toe tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86708","name":"Hepatitis a antibody","description":"Hepatitis a antibody (haab)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54535","name":"Extensive testis surgery","description":"Orchiectomy, radical, for tumor; with abdominal exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34001","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3461.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["AW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82658","name":"Enzyme cell activity ra","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90808","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25023","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2559.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1976.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81236","name":"Ezh2 gene full gene sequence","description":"Ezh2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96125","name":"Cognitive test by hc pro","description":"Standardized cognitive performance testing (eg, ross information processing assessment) per hour of a qualified health care professionals time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6009","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61575","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82946","name":"Glucagon tolerance test","description":"Glucagon tolerance test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36835","name":"Insertion thomas shunt","description":"Insertion of thomas shunt (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63040","name":"Laminotomy single cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46285","name":"Remove anal fist 2 stage","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2500.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22842","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34841","name":"Endovasc visc aorta 1 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96445","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51520","name":"Removal of bladder lesion","description":"Cystotomy; for simple excision of vesical neck (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0638","name":"Standing frame sys","description":"Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0451","name":"Devlopment test interpt&rep","description":"Development testing, with interpretation and report, per standardized instrument form","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62322","name":"Njx interlaminar lmbr/sac","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33215","name":"Reposition pacing-defib lead","description":"Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64823","name":"Sympathectomy supfc palmar","description":"Sympathectomy; superficial palmar arch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67903","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54440","name":"Repair of penis","description":"Plastic operation of penis for injury","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19082","name":"Bx breast add lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83898","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01935","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6213","name":"Foam drg >16<=48 sq in w/bdr","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37785","name":"Ligate/divide/excise vein","description":"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51080","name":"Drainage of bladder abscess","description":"Drainage of perivesical or prevesical space abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63087","name":"Remov vertbr dcmprn thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11771","name":"Exc pilonidal cyst xtnsv","description":"Excision of pilonidal cyst or sinus; extensive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32906","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages); with closure of bronchopleural fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1320.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38211","name":"Tumor cell deplete of harvst","description":"Transplant preparation of hematopoietic progenitor cells; tumor cell depletion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49320","name":"Diag laparo separate proc","description":"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1815","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"M0246","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28525","name":"Treat toe fracture","description":"Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0243","name":"Toilet rail","description":"Toilet rail, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G2252","name":"Brief chkin by md/qhp, 11-20","description":"Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor le","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0128","name":"Corf skilled nursing service","description":"Direct (face-to-face with patient) skilled nursing services of a registered nurse provided in a comprehensive outpatient rehabilitation facility, each 10 minutes beyond the first 5 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26675","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21825","name":"Treat sternum fracture","description":"Open treatment of sternum fracture with or without skeletal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45905","name":"Dilation of anal sphincter","description":"Dilation of anal sphincter (separate procedure) under anesthesia other than local","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0149T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0322","name":"Home h physio data collec tr","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17111","name":"Destruction b9 lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69705","name":"Nps surg dilat eust tube uni","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27607","name":"Treat lower leg bone lesion","description":"Incision (eg, osteomyelitis or bone abscess), leg or ankle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93792","name":"Pt/caregiver traing home inr","description":"Patient/caregiver training for initiation of home international normalized ratio (inr) monitoring under the direction of a physician or other qualified health care professional, face-to-face, including use and care of the inr monitor, obtaining blood sample, instructions for reporting home inr test ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40831","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; over 2.5 cm or complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35152","name":"Repair ruptd popliteal art","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0154A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29440","name":"Adding walker to prev cast","description":"Adding walker to previously applied cast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28285","name":"Repair of hammertoe","description":"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66830","name":"Removal of lens lesion","description":"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33989","name":"Removal of left heart vent","description":"Removal of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57284","name":"Repair paravag defect open","description":"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62201","name":"Brain cavity shunt w/scope","description":"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38381","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; thoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54304","name":"Revision of penis","description":"Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57720","name":"Revision of cervix","description":"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11104","name":"Punch bx skin single lesion","description":"Punch biopsy of skin (including simple closure, when performed); single lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15850","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43180","name":"Esophagoscopy rigid trnso","description":"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, zenkers diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51100","name":"Drain bladder by needle","description":"Aspiration of bladder; by needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54231","name":"Dynamic cavernosometry","description":"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52005","name":"Cysto w/urtrl cathj","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1744.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27498","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99281","name":"Emr dpt vst mayx req phy/qhp","description":"Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57270","name":"Repair of bowel pouch","description":"Repair of enterocele, abdominal approach (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5160.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43242","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11440","name":"Exc face-mm b9+marg 0.5 cm/<","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67141","name":"Proph rta dtchmnt crtx dthrm","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96152","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58940","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3752.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55600","name":"Vesiculotomy","description":"Vesiculotomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34830","name":"Open aortic tube prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; tube prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61598","name":"Transpetrosal approach/skull","description":"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92072","name":"Fitg c-lens keratoconus 1st","description":"Fitting of contact lens for management of keratoconus, initial fitting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80406","name":"Acth stimulation panel","description":"Acth stimulation panel; for 3 beta-hydroxydehydrogenase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87477","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21015","name":"Resect face/scalp tum < 2 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; less than 2 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28805","name":"Amputation thru metatarsal","description":"Amputation, foot; transmetatarsal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92020","name":"Gonioscopy","description":"Gonioscopy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82139","name":"Amino acids quan 6 or more","description":"Amino acids, 6 or more amino acids, quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27226","name":"Treat hip wall fracture","description":"Open treatment of posterior or anterior acetabular wall fracture, with internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4725","name":"Dialys sol fld vol > 4999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37228","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4994.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"17264","name":"Dstrj mal les t/a/l 3.1-4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86729","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28515","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43773","name":"Lap replace gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86060","name":"Antistreptolysin o titer","description":"Antistreptolysin 0; titer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99152","name":"Mod sed same phys/qhp 5/>yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69802","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24670","name":"Cltx ulnar fx prox w/o mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63295","name":"Repair laminectomy defect","description":"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36416","name":"Collj capillary blood spec","description":"Collection of capillary blood specimen (eg, finger, heel, ear stick)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47701","name":"Bile duct revision","description":"Portoenterostomy (eg, kasai procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82491","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32405","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20808","name":"Replantation hand complete","description":"Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96522","name":"Refill/maint pump/resvr syst","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81187","name":"Cnbp gene detc abnor allele","description":"Cnbp (cchc-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21556","name":"Exc neck tum deep < 5 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96574","name":"Dbrdmt prmlg les w/pdt","description":"Debridement of premalignant hyperkeratotic lesion(s) (ie, targeted curettage, abrasion) followed with photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26418","name":"Repair finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87300","name":"Ag detection polyval if","description":"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28890","name":"Hi enrgy eswt plantar fascia","description":"Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86817","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, multiple antigens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4590","name":"Special casting material","description":"Special casting material (e.g., fiberglass)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33513","name":"Cabg vein four","description":"Coronary artery bypass, vein only; 4 coronary venous grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29860","name":"Hip arthroscopy dx","description":"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40840","name":"Reconstruction of mouth","description":"Vestibuloplasty; anterior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86340","name":"Intrinsic factor antibody","description":"Intrinsic factor antibodies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22523","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5883.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4337.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32662","name":"Thoracoscopy w/mediast exc","description":"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69740","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52342","name":"Cysto w/up stricture tx","description":"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28291","name":"Corrj halux rigdus w/implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96934","name":"Rcm img acquisj&i&r ea addl","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57505","name":"Endocervical curettage","description":"Endocervical curettage (not done as part of a dilation and curettage)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28446","name":"Opn osteochondrl agrft talus","description":"Open osteochondral autograft, talus (includes obtaining graft[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92317","name":"C-lens fitg tech corneosclrl","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneoscleral lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37250","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66172","name":"Incision of eye","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85097","name":"Bone marrow interpretation","description":"Bone marrow, smear interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"22905","name":"Rad resect abd tumor 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26685","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11641","name":"Exc f/e/e/n/l mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33510","name":"Cabg vein single","description":"Coronary artery bypass, vein only; single coronary venous graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15920","name":"Exc coccygl pr ulc prim sutr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23525","name":"Cltx strnclav dislc w/mnpj","description":"Closed treatment of sternoclavicular dislocation; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29916","name":"Hip arthro w/labral repair","description":"Arthroscopy, hip, surgical; with labral repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36224","name":"Place cath carotd art","description":"Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44203","name":"Lap resect s/intestine addl","description":"Laparoscopy, surgical; each additional small intestine resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23331","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37207","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31520","name":"Dx laryngoscopy newborn","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87472","name":"Bartonella dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0368","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11624","name":"Exc s/n/h/f/g mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19120","name":"Removal of breast lesion","description":"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49653","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90953","name":"Esrd serv 1 visit p mo <2yrs","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87900","name":"Phenotype infect agent drug","description":"Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3262.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0269T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27369","name":"Njx cntrst kne arthg/ct/mri","description":"Injection procedure for contrast knee arthrography or contrast enhanced ct/mri knee arthrography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64782","name":"Remove limb nerve lesion","description":"Excision of neuroma; hand or foot, except digital nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34825","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33777","name":"Rpr tga bfl rpr sbpulm obstr","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62323","name":"Njx interlaminar lmbr/sac","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluorosc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95170","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17266","name":"Dstrj mal les t/a/l >4.0 cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44345","name":"Revision of colostomy","description":"Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2970.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82633","name":"Desoxycorticosterone","description":"Desoxycorticosterone, 11-","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25263","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49492","name":"Rpr ing hern premie blocked","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44380","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43214","name":"Esophagosc dilate balloon 30","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54680","name":"Relocation of testis(es)","description":"Transplantation of testis(es) to thigh (because of scrotal destruction)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43116","name":"Partial removal of esophagus","description":"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54161","name":"Circum 28 days or older","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25651","name":"Perq skel fix ulnar styld fx","description":"Percutaneous skeletal fixation of ulnar styloid fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36513","name":"Apheresis platelets","description":"Therapeutic apheresis; for platelets","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68335","name":"Revise/graft eyelid lining","description":"Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56633","name":"Vulvectomy radical complete","description":"Vulvectomy, radical, complete;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96170","name":"Hlth bhv ivntj fam wo pt 1st","description":"Health behavior intervention, family (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45130","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; perineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19105","name":"Cryosurg ablate fa each","description":"Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45342","name":"Sigmoidoscopy w/us guide bx","description":"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69636","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23335","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97533","name":"Sensory integration","description":"Sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands, direct (one-on-one) patient contact, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28022","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83858","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58552","name":"Laparo-vag hyst incl t/o","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86156","name":"Cold agglutinin screen","description":"Cold agglutinin; screen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46045","name":"I&d absc tranal under anes","description":"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35482","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83825","name":"Assay of mercury","description":"Mercury, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33465","name":"Replace tricuspid valve","description":"Replacement, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2395.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64876","name":"Repair nerve/shorten bone","description":"Suture of nerve; requiring shortening of bone of extremity (list separately in addition to code for nerve suture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59610","name":"Vbac delivery","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care, after previous cesarean delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1974.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3204","name":"Hightop w/ supp/pronator inf","description":"Orthopedic shoe, hightop with supinator or pronator, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49496","name":"Rpr ing hernia baby blocked","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35883","name":"Revj fem anast nonautog grf","description":"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51050","name":"Removal of bladder stone","description":"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28041","name":"Exc foot/toe tum dep 1.5cm/>","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57426","name":"Revise prosth vag graft lap","description":"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6978.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32553","name":"Ins mark thor for rt perq","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19296","name":"Place po breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26593","name":"Release muscles of hand","description":"Release, intrinsic muscles of hand, each muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85291","name":"Clot factor xiii fibrin scrn","description":"Clotting; factor xiii (fibrin stabilizing), screen solubility","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11041","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28635","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64568","name":"Opn impltj crnl nrv nea&pg","description":"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55865","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27685","name":"Revision of lower leg tendon","description":"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31255","name":"Nsl/sins ndsc w/tot ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81286","name":"Fxn gene full gene sequence","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; full gene sequence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4176","name":"Parenteral sol amino acid 7-","description":"Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62143","name":"Rpl b1 flp/prostc plate skl","description":"Replacement of bone flap or prosthetic plate of skull","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43641","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82803","name":"Blood gases any combination","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15819","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51597","name":"Removal of pelvic structures","description":"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61711","name":"Fusion of skull arteries","description":"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48153","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0453","name":"Cont intraop neuro monitor","description":"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64902","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; multiple strands (cable) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27759","name":"Treatment of tibia fracture","description":"Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35537","name":"Art byp grft aortoiliac","description":"Bypass graft, with vein; aortoiliac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64413","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87253","name":"Virus inoculate tissue addl","description":"Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization, immunofluorescence stain), each isolate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55845","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78465","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87116","name":"Mycobacteria culture","description":"Culture, tubercle or other acid-fast bacilli (eg, tb, afb, mycobacteria) any source, with isolation and presumptive identification of isolates","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35371","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; common femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55870","name":"Electroejaculation","description":"Electroejaculation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2474.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23532","name":"Optx strclv dslc aq/chrn grf","description":"Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45384","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90867","name":"Tcranial magn stim tx plan","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; initial, including cortical mapping, motor threshold determination, delivery and management","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42420","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61583","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94002","name":"Vent mgmt inpat init day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50782","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of duplicated ureter to bladder","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28291","name":"Corrj halux rigdus w/implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40525","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with local flap (eg, estlander or fan)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23500","name":"Cltx clavicular fx w/o mnpj","description":"Closed treatment of clavicular fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2212","name":"Prolong outpt/office vis","description":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or w","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82941","name":"Assay of gastrin","description":"Gastrin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44010","name":"Incision of small bowel","description":"Duodenotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0237","name":"Therapeutic procd strg endur","description":"Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83873","name":"Assay of csf protein","description":"Myelin basic protein, cerebrospinal fluid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4301","name":"Implantable access syst perc","description":"Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22851","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99488","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57522","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26075","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33548","name":"Restore/remodel ventricle","description":"Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, svr, saver, dor procedures)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20660","name":"Apply rem fixation device","description":"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26100","name":"Biopsy hand joint lining","description":"Arthrotomy with biopsy; carpometacarpal joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22861","name":"Rev rplcm arthrp 1ntrspc crv","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95144","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, single dose vial(s) (specify number of vials)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50830","name":"Revise urine flow","description":"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33963","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87046","name":"Stool cultr aerobic bact ea","description":"Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58900","name":"Biopsy of ovary(s)","description":"Biopsy of ovary, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98972","name":"Nqhp ol dig assmt&mgmt 21+","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0244","name":"Toilet seat raised","description":"Raised toilet seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64454","name":"Njx aa&/strd gnclr nrv brnch","description":"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87164","name":"Dark field exam spec collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99153","name":"Mod sed same phys/qhp ea","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64565","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30220","name":"Insert nasal septal button","description":"Insertion, nasal septal prosthesis (button)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96374","name":"Ther/proph/diag inj iv push","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5693.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27440","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25360","name":"Revision of ulna","description":"Osteotomy; ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54056","name":"Cryosurgery penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C9113","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35306","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20225","name":"Bone biopsy trocar/ndl deep","description":"Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43752","name":"Nasal/orogastric w/tube plmt","description":"Naso- or oro-gastric tube placement, requiring physicians skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67220","name":"Treatment of choroid lesion","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33505","name":"Repair artery w/tunnel","description":"Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (takeuchi procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1799.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50398","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26080","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21081","name":"Impres&prep mndbl res prosth","description":"Impression and custom preparation; mandibular resection prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23552","name":"Optx acrclv dslc aq/chrn grf","description":"Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63276","name":"Bx/exc xdrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1623.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77071","name":"Mnl appl strs jt radiography","description":"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82926","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60545","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0409","name":"Corf related serv 15 mins ea","description":"Social work and psychological services, directly relating to and/or furthering the patients rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26420","name":"Repair/graft finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43226","name":"Esoph endoscopy dilation","description":"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26508","name":"Release thumb contracture","description":"Release of thenar muscle(s) (eg, thumb contracture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"49320","name":"Diag laparo separate proc","description":"Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50240","name":"Nephrectomy partial","description":"Nephrectomy, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11006","name":"Dbrdmt skin xtrnl gent per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87254","name":"Virus inoculation shell via","description":"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3206","name":"Hightop w/ supp/pronator chi","description":"Orthopedic shoe, hightop with supinator or pronator, child","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"T4537","name":"Reusable underpad bed size","description":"Incontinence product, protective underpad, reusable, bed size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35331","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; abdominal aorta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84375","name":"Chromatogram assay sugars","description":"Sugars, chromatographic, tlc or paper chromatography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67221","name":"Ocular photodynamic ther","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87107","name":"Fungi identification mold","description":"Culture, fungi, definitive identification, each organism; mold","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33886","name":"Delayed plmt dstl xtn prosth","description":"Delayed placement of distal extension prosthesis(es) from the level of the left subclavian artery to the celiac artery, after endovascular repair of descending thoracic aorta, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological superv","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36000","name":"Place needle in vein","description":"Introduction of needle or intracatheter, vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21082","name":"Impres&prep paltl aug prosth","description":"Impression and custom preparation; palatal augmentation prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0109T","name":"Heat quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using heat-pain stimuli to assess small nerve fiber sensation and hyperalgesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"C1887","name":"Catheter, guiding","description":"Catheter, guiding (may include infusion/perfusion capability)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52283","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with steroid injection into stricture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28760","name":"Fusion of big toe joint","description":"Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, jones type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21138","name":"Rdctj forehead cntrg&prostc","description":"Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86325","name":"Other immunoelectrophoresis","description":"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2770","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31541","name":"Larynscop w/tumr exc + scope","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83914","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47801","name":"Placement bile duct support","description":"Placement of choledochal stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62161","name":"Dissect brain w/scope","description":"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32659","name":"Thoracoscopy w/sac drainage","description":"Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61150","name":"Bur hol/trph drg brn abs/cst","description":"Burr hole(s) or trephine; with drainage of brain abscess or cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43245","name":"Egd dilate stricture","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63082","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4528","name":"Adult size pull-on xl","description":"Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69632","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4245","name":"Alcohol wipes per box","description":"Alcohol wipes, per box","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65112","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21495","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29897","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95017","name":"All tstg perq&iq w/venoms","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2400.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49452","name":"Replace g-j tube perc","description":"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94777","name":"Ped home apnea mntr rvw i&r","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3911","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1779.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67961","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6018","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68801.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32556","name":"Insert cath pleura w/o image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29325","name":"Appl hip spica cast1&1/2","description":"Application of hip spica cast; 1 and one-half spica or both legs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27685","name":"Revision of lower leg tendon","description":"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21931","name":"Exc back les sc 3 cm/>","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38205","name":"Harvest allogeneic stem cell","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27536","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17350.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5329.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11760","name":"Repair of nail bed","description":"Repair of nail bed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15836","name":"Exc excessive skin arm","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66991","name":"Xcapsl ctrc rmvl insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drai","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87502","name":"Influenza dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27550","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8270","name":"Enuresis alarm","description":"Enuresis alarm, using auditory buzzer and/or vibration device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15760","name":"Composite skin graft","description":"Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29846","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87621","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68840","name":"Explore/irrigate tear ducts","description":"Probing of lacrimal canaliculi, with or without irrigation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93462","name":"L hrt cath trnsptl puncture","description":"Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21122","name":"Geniop sldg osteot 2/>","description":"Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33025","name":"Incision of heart sac","description":"Creation of pericardial window or partial resection for drainage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28230","name":"Incision of foot tendon(s)","description":"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17110","name":"Destruction b9 les up to 14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49600","name":"Repair umbilical lesion","description":"Repair of small omphalocele, with primary closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2563.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81271","name":"Htt gene detc abnor alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"C1894","name":"Intro/sheath, non-laser","description":"Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0407","name":"Inpt/tele follow up 25","description":"Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42425","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69436","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61026","name":"Injection into brain canal","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32201","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63661","name":"Remove spine eltrd perq aray","description":"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11313","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17260","name":"Dstrj mal les t/a/l 0.5 cm/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64421","name":"Njx aa&/strd ntrcost nrv ea","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54332","name":"Revise penis/urethra","description":"1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49446","name":"Change g-tube to g-j perc","description":"Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28430","name":"Cltx talus fracture w/o mnpj","description":"Closed treatment of talus fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33017","name":"Prcrd drg 6yr+ w/o cgen car","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; 6 years and older without congenital cardiac anomaly","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61860","name":"Implant neuroelectrodes","description":"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22859","name":"Insj biomechanical device","description":"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99174","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20938","name":"Sp bone agrft struct add-on","description":"Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67961","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85366","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); paracoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88318","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35601","name":"Bpg com crtd-ipsi int crtd","description":"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21073","name":"Mnpj of tmj w/anesth","description":"Manipulation of temporomandibular joint(s) (tmj), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88166","name":"Cytopath tbs c/v auto redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15151.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99251","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7499","name":"Upper extremity prosthes nos","description":"Upper extremity prosthesis, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2061.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4641","name":"Radiopharm dx agent noc","description":"Radiopharmaceutical, diagnostic, not otherwise classified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35551","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65155","name":"Reinsert ocular implant","description":"Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0441T","name":"Abltj perc lxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19364","name":"Brst rcnstj free flap","description":"Breast reconstruction; with free flap (eg, ftram, diep, siea, gap flap)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61120","name":"Burr hole for ventr puncture","description":"Burr hole(s) for ventricular puncture (including injection of gas, contrast media, dye, or radioactive material)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35616","name":"Bpg subclavian-axillary","description":"Bypass graft, with other than vein; subclavian-axillary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15657.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81309","name":"Pik3ca gene trgt seq alys","description":"Pik3ca (phosphatidylinositol-4, 5-biphosphate 3-kinase, catalytic subunit alpha) (eg, colorectal and breast cancer) gene analysis, targeted sequence analysis (eg, exons 7, 9, 20)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26536","name":"Revise/implant finger joint","description":"Arthroplasty, interphalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92627","name":"Eval aud funcj ea addl 15","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2847.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47144","name":"Prep donor liver 3-segment","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegmen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33861","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2469.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0444T","name":"1st plmt drug elut oc ins","description":"Initial placement of a drug-eluting ocular insert under one or more eyelids, including fitting, training, and insertion, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4538","name":"Diaper serv reusable diaper","description":"Diaper service, reusable diaper, each diaper","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64505","name":"N block spenopalatine gangl","description":"Injection, anesthetic agent; sphenopalatine ganglion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49406","name":"Image cath fluid peri/retro","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5299.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33365","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50280","name":"Exc/unroofing cyst kidney","description":"Excision or unroofing of cyst(s) of kidney","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23140","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49572","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26541","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42970","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22804","name":"Arthrd pst dfrm 13+ vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15272","name":"Skin sub graft t/a/l add-on","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27514","name":"Treatment of thigh fracture","description":"Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42971","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33965","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42971","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2053.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25025","name":"Decompress forearm 2 spaces","description":"Decompression fasciotomy, forearm and/or wrist, flexor and extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35188","name":"Rpr acq av fistula head&neck","description":"Repair, acquired or traumatic arteriovenous fistula; head and neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27395","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63304","name":"Remove vert idrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80435","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for growth hormone deficiency this panel must include the following: glucose (82947 x 5) human growth hormone (hgh) (83003 x 5)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0085","name":"Care man h v ext pt 75 m","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29856","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); bicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43250","name":"Egd cautery tumor polyp","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92355","name":"Fitg spect lw vis cmpnd lens","description":"Fitting of spectacle mounted low vision aid; telescopic or other compound lens system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27659","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23221","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33858","name":"As-aort grf f/aortic dsj","description":"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35241","name":"Rpr blvsl vn grf ntrthrc w/b","description":"Repair blood vessel with vein graft; intrathoracic, with bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54000","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53860","name":"Transurethral rf treatment","description":"Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1699.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27620","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66820","name":"Incision secondary cataract","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (ziegler or wheeler knife)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33475","name":"Replacement pulmonary valve","description":"Replacement, pulmonary valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2024.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33412","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with transventricular aortic annulus enlargement (konno procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"R0070","name":"Transport portable x-ray","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3107.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27125","name":"Partial hip replacement","description":"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27767","name":"Cltx post ankle fx","description":"Closed treatment of posterior malleolus fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86822","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38765","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39401","name":"Mediastinoscpy w/medstnl bx","description":"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82380","name":"Assay of carotene","description":"Carotene","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82938","name":"Gastrin test","description":"Gastrin after secretin stimulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49215","name":"Excise sacral spine tumor","description":"Excision of presacral or sacrococcygeal tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21198","name":"Reconstr lwr jaw segment","description":"Osteotomy, mandible, segmental;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38213","name":"Platelet deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; platelet depletion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35570","name":"Art byp tibial-tib/peroneal","description":"Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2055.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36833","name":"Av fistula revision","description":"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55150","name":"Removal of scrotum","description":"Resection of scrotum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81173","name":"Ar gene full gene sequence","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; full gene sequence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33768","name":"Anast cavopulm sec sup v/c","description":"Anastomosis, cavopulmonary, second superior vena cava (list separately in addition to primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26255","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28285","name":"Repair of hammertoe","description":"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11008","name":"Rmv prstc mtrl/mesh abd wall","description":"Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue infection) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58262","name":"Vag hyst including t/o","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2003","name":"Post-d/c h vst new pt 45 m","description":"Moderate (45 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92519","name":"Vemp tst i&r cervical&ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp) and ocular (ovemp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87490","name":"Chlmyd trach dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15360","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23180","name":"Prtl excision bone clavicle","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87904","name":"Phenotype dna hiv w/clt add","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; each additional drug tested (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2083","name":"Visit esketamine, > 56m","description":"Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of  greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observ","date_of_service":"2026-06-06","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","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25630","name":"Cltx carpl fx w/o mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28225","name":"Release of foot tendon","description":"Tenolysis, extensor, foot; single tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27725","name":"Repair of lower leg","description":"Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82390","name":"Assay of ceruloplasmin","description":"Ceruloplasmin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33364","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open iliac artery approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34847","name":"Visc & infraren abd 3 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28435","name":"Cltx talus fracture w/mnpj","description":"Closed treatment of talus fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97033","name":"App mdlty 1+iontphrsis ea 15","description":"Application of a modality to 1 or more areas; iontophoresis, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81167","name":"Brca2 gene full dup/del alys","description":"Brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17264","name":"Dstrj mal les t/a/l 3.1-4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57107","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28298","name":"Cor hlx vlgs prx phlx osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87425","name":"Rotavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; rotavirus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87651","name":"Strep a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94669","name":"Mechanical chest wall oscill","description":"Mechanical chest wall oscillation to facilitate lung function, per session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0507","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83857","name":"Assay of methemalbumin","description":"Methemalbumin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47543","name":"Endoluminal bx biliary tree","description":"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80047","name":"Basic metablc pnl ionized ca","description":"Basic metabolic panel (calcium, ionized) this panel must include the following: calcium, ionized (82330) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552T","name":"Low-level laser therapy","description":"Low-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5020","name":"Conformity evaluation","description":"Conformity evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2528.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86890","name":"Autologous blood process","description":"Autologous blood or component, collection processing and storage; predeposited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64461","name":"Pvb thoracic single inj site","description":"Paravertebral block (pvb) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64905","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; first stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25390","name":"Shorten radius or ulna","description":"Osteoplasty, radius or ulna; shortening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26483","name":"Transplant/graft hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21143","name":"Rcnstj mdface lefort i 3/>pc","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, without bone graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66174","name":"Trluml dil aq o/f can w/o st","description":"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4341.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4750","name":"Art or venous blood tubing","description":"Blood tubing, arterial or venous, for hemodialysis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15956","name":"Exc trchntr pr ulc prep flap","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50045","name":"Nephrotomy w/exploration","description":"Nephrotomy, with exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64836","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; ulnar motor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33364","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open iliac artery approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["KM","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57545","name":"Remove cervix/repair pelvis","description":"Excision of cervical stump, abdominal approach; with pelvic floor repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4232.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28294","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36228","name":"Place cath intracranial art","description":"Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (lis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11057","name":"Parng/cutg b9 hyprkr les >4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35011","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38214","name":"Volume deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90824","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9143","name":"Warfarin respon genetic test","description":"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33726","name":"Repair pul venous stenosis","description":"Repair of pulmonary venous stenosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27503","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48001","name":"Placement of drain pancreas","description":"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0437","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4081.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66174","name":"Trluml dil aq o/f can w/o st","description":"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); without retention of device or stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4495","name":"Thigh length surg stocking","description":"Surgical stockings thigh length, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0064A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88741","name":"Transcutaneous methb","description":"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1811.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35518","name":"Art byp grft axillary-axilry","description":"Bypass graft, with vein; axillary-axillary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4232","name":"Syringe w/needle insulin 3cc","description":"Syringe with needle for external insulin pump, sterile, 3 cc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69645","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4211","name":"Supp for self-adm injections","description":"Supplies for self-administered injections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21820","name":"Treat sternum fracture","description":"Closed treatment of sternum fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4657.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33845","name":"Excision coa w/graft","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96417","name":"Chemo iv infus each addl seq","description":"Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0252","name":"Pet imaging initial dx","description":"Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64861","name":"Repair of arm nerves","description":"Suture of; brachial plexus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7929.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3199.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28106","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66852","name":"Removal of lens material","description":"Removal of lens material; pars plana approach, with or without vitrectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21184","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2082","name":"Visit esketamine 56m or less","description":"Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0044A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93528","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20931","name":"Sp bone algrft struct add-on","description":"Allograft, structural, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19342","name":"Insj/rplcmt brst implt sep d","description":"Insertion or replacement of breast implant on separate day from mastectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49593","name":"Rpr aa hrn 1st 3-10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49411","name":"Ins mark abd/pel for rt perq","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87487","name":"Chlmyd pneum dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"39520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50430","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2123.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61576","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3832.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4550","name":"Surgical trays","description":"Surgical trays","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5060.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64755","name":"Incision of stomach nerves","description":"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1566.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24320","name":"Tenoplasty elbow to sho 1","description":"Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (seddon-brookes type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43260","name":"Ercp w/specimen collection","description":"Endoscopic retrograde cholangiopancreatography (ercp); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96119","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61316","name":"Inc&subq plmt crnl bone grf","description":"Incision and subcutaneous placement of cranial bone graft (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43252","name":"Egd optical endomicroscopy","description":"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65275","name":"Repair of eye wound","description":"Repair of laceration; cornea, nonperforating, with or without removal foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L0210","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42450","name":"Excise sublingual gland","description":"Excision of sublingual gland","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35256","name":"Repair blvsl vn grf lxtr","description":"Repair blood vessel with vein graft; lower extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0544T","name":"Tcat mv annulus rcnstj","description":"Transcatheter mitral valve annulus reconstruction, with implantation of adjustable annulus reconstruction device, percutaneous approach including transseptal puncture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15936","name":"Exc sac pr ulc prep mus flap","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50580","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92652","name":"Aep thrshld est mlt freq i&r","description":"Auditory evoked potentials; for threshold estimation at multiple frequencies, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25109","name":"Excise tendon forearm/wrist","description":"Excision of tendon, forearm and/or wrist, flexor or extensor, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82575","name":"Creatinine clearance test","description":"Creatinine; clearance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1748.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26742","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96150","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42830","name":"Removal of adenoids","description":"Adenoidectomy, primary; younger than age 12","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43333","name":"Transab esoph hiat hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2657.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36833","name":"Av fistula revision","description":"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15851","name":"Removal sutr/staple req anes","description":"Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86813","name":"Hla typing a b or c","description":"Hla typing; a, b, or c, multiple antigens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2708.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26861","name":"Fusion of finger jnt add-on","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3651","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10509","10512","10516","10524","10537","10541","10542","10579","10910","10912","10914","10915","10916","10917","10918","10919","10921","10922","10924","10925","10926","10928","10930","10932","10933","10940","10941","10943","10949","10950","10953","10958","10959","10963","10969","10973","10975","10979","10981","10985","10987","10988","10990","10992","10996","10997","10998","12015","12017","12029","12037","12042","12050","12051","12058","12060","12075","12083","12087","12106","12115","12124","12125","12130","12132","12136","12165","12167","12172","12173","12174","12176","12184","12192","12195","12401","12402","12404","12405","12406","12407","12409","12410","12411","12412","12413","12414","12416","12417","12418","12419","12420","12421","12422","12423","12424","12427","12428","12429","12430","12431","12432","12433","12434","12435","12436","12438","12439","12440","12441","12442","12443","12444","12446","12448","12449","12450","12451","12452","12453","12454","12455","12456","12457","12458","12459","12460","12461","12463","12464","12465","12466","12468","12470","12471","12472","12473","12474","12475","12477","12480","12481","12482","12483","12484","12485","12486","12487","12489","12490","12491","12492","12493","12494","12495","12496","12498","12501","12502","12503","12504","12506","12507","12508","12510","12511","12512","12513","12514","12515","12516","12517","12518","12520","12521","12522","12523","12524","12525","12526","12527","12528","12529","12530","12531","12533","12534","12537","12538","12540","12541","12542","12543","12544","12545","12546","12547","12548","12549","12550","12551","12552","12553","12555","12561","12563","12564","12565","12566","12567","12568","12569","12570","12571","12572","12574","12575","12577","12578","12580","12581","12582","12583","12584","12585","12586","12588","12589","12590","12592","12593","12594","12601","12602","12603","12604","12701","12719","12720","12721","12722","12723","12724","12725","12726","12727","12729","12732","12733","12734","12736","12737","12738","12740","12741","12742","12743","12745","12746","12747","12748","12749","12750","12751","12752","12754","12758","12759","12760","12762","12763","12764","12765","12766","12767","12768","12769","12770","12771","12775","12776","12777","12778","12779","12780","12781","12782","12783","12784","12785","12786","12787","12788","12789","12790","12791","12792","13731","13739","13740","13750","13751","13752","13753","13755","13756","13757","13774","13775","13782","13783","13786","13788","13804","13806","13837","13838","13839","13842","13846","13847","13856","13860"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88165","name":"Cytopath tbs c/v redo","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and rescreening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61682","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66984","name":"Xcapsl ctrc rmvl w/o ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58293","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11310","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27307","name":"Incision of thigh tendons","description":"Tenotomy, percutaneous, adductor or hamstring; multiple tendons","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15769","name":"Grfg autol soft tiss dir exc","description":"Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58611","name":"Ligate oviduct(s) add-on","description":"Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44379","name":"S bowel endoscope w/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87497","name":"Cytomeg dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2928.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86941","name":"Hemolysins/agglutinins","description":"Hemolysins and agglutinins; incubated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88283","name":"Chromosome banding study","description":"Chromosome analysis; additional specialized banding technique (eg, nor, c-banding)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86781","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26910","name":"Amputate metacarpal bone","description":"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2072.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99457","name":"Rpm tx mgmt 1st 20 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0064A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33521","name":"Cabg artery-vein four","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99175","name":"Induction of vomiting","description":"Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29581","name":"Appl multlayer cmprn sys leg","description":"Application of multi-layer compression system; leg (below knee), including ankle and foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58953","name":"Tah rad dissect for debulk","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4155","name":"Ef incomplete/modular","description":"Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 un","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44900","name":"I&d appendix abscess open","description":"Incision and drainage of appendiceal abscess, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50540","name":"Revision of horseshoe kidney","description":"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E1340","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93590","name":"Perq transcath cls mitral","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83825","name":"Assay of mercury","description":"Mercury, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43205","name":"Esophagus endoscopy/ligation","description":"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1872.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5329.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42815","name":"Excision of neck cyst","description":"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77417","name":"Ther radiology port image(s)","description":"Therapeutic radiology port image(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"11200","name":"Rmvl skin tags up to&inc 15","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3733.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00634","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95723","name":"Eeg phy/qhp>60<84 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of eeg recording, without video","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56442","name":"Hymenotomy","description":"Hymenotomy, simple incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44661","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; with intestine and/or bladder resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78593","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42844","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53855","name":"Insert prost urethral stent","description":"Insertion of a temporary prostatic urethral stent, including urethral measurement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10006","name":"Fna bx w/us gdn ea addl","description":"Fine needle aspiration biopsy, including ultrasound guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31040","name":"Exploration behind upper jaw","description":"Pterygomaxillary fossa surgery, any approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13151","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96405","name":"Chemo intralesional up to 7","description":"Chemotherapy administration; intralesional, up to and including 7 lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86078","name":"Phys blood bank serv reactj","description":"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0143","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6206","name":"Contact layer <= 16 sq in","description":"Contact layer, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96367","name":"Tx/proph/dg addl seq iv inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65810","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22534","name":"Arthrd lat xtrcvtry tq ea ad","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46942","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21123","name":"Geniop sldg augmentation","description":"Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2011","name":"Alcohol/sub misuse assess","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99453","name":"Rem mntr physiol param setup","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33750","name":"Shunt subclavian to pulm art","description":"Shunt; subclavian to pulmonary artery (blalock-taussig type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80200","name":"Assay of tobramycin","description":"Tobramycin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15740","name":"Island pedicle flap graft","description":"Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22114","name":"Remove part lumbar vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28126","name":"Partial removal of toe","description":"Resection, partial or complete, phalangeal base, each toe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66150","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trephination with iridectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32669","name":"Thoracoscopy remove segment","description":"Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3315.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85347","name":"Coagulation time activated","description":"Coagulation time; activated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62147","name":"Crnop w/autograft>5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62328","name":"Dx lmbr spi pnxr w/fluor/ct","description":"Spinal puncture, lumbar, diagnostic; with fluoroscopic or ct guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9609.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26775","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50525","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51520","name":"Removal of bladder lesion","description":"Cystotomy; for simple excision of vesical neck (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38530","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, internal mammary node(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69905","name":"Remove inner ear","description":"Labyrinthectomy; transcanal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58920","name":"Partial removal of ovary(s)","description":"Wedge resection or bisection of ovary, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14696.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33259","name":"Ablate atria w/bypass add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26025","name":"Drainage of palm bursa","description":"Drainage of palmar bursa; single, bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90959","name":"Esrd serv 1 vst p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per mont","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62350","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; without laminectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77523","name":"Proton trmt intermediate","description":"Proton treatment delivery; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0298T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45112","name":"Removal of rectum","description":"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1489.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11312","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83866","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50725","name":"Release/revise ureter","description":"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87324","name":"Clostridium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; clostridium difficile toxin(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51720","name":"Treatment of bladder lesion","description":"Bladder instillation of anticarcinogenic agent (including retention time)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7534.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81020","name":"Urinalysis glass test","description":"Urinalysis; 2 or 3 glass test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27244","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28305","name":"Incise/graft midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes obtaining graft) (eg, fowler type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44151","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, without proctectomy; with continent ileostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52007","name":"Cysto urtrl cathj brush bx","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95710","name":"Eeg w/o vid ea 12-26hr cont","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96110","name":"Developmental screen w/score","description":"Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0869","name":"Pwc gp 4 std cap chair","description":"Power wheelchair, group 4 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3914.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63271","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"14021","name":"Tis trnfr s/a/l 10.1-30 sqcm","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27429","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26040","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27603","name":"Drain lower leg lesion","description":"Incision and drainage, leg or ankle; deep abscess or hematoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82397","name":"Chemiluminescent assay","description":"Chemiluminescent assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64616","name":"Chemodenerv musc neck dyston","description":"Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3216","name":"Orthoped ladies shoes dpth i","description":"Orthopedic footwear, ladies shoe, depth inlay, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28313","name":"Repair deformity of toe","description":"Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20611","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50561","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27057","name":"Buttock fasciotomy w/dbrdmt","description":"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) with debridement of nonviable muscle, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86413","name":"Sars-cov-2 antb quantitative","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) antibody, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20924","name":"Removal of tendon for graft","description":"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65800","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87640","name":"Staph a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); staphylococcus aureus, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33211","name":"Insert card electrodes dual","description":"Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81443","name":"Genetic tstg severe inh cond","description":"Genetic testing for severe inherited conditions (eg, cystic fibrosis, ashkenazi jewish-associated disorders [eg, bloom syndrome, canavan disease, fanconi anemia type c, mucolipidosis type vi, gaucher disease, tay-sachs disease], beta hemoglobinopathies, phenylketonuria, galactosemia), genomic sequen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65103","name":"Remove eye/insert implant","description":"Enucleation of eye; with implant, muscles not attached to implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20665","name":"Rmvl tongs/halo anthr indiv","description":"Removal of tongs or halo applied by another individual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2232.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20704","name":"Mnl prep&insj i-artic rx dev","description":"Manual preparation and insertion of drug-delivery device(s), intra-articular (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0314","name":"Counsel immune <21 16-30 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62290","name":"Njx px discography lumbar","description":"Injection procedure for discography, each level; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27227","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86304","name":"Immunoassay tumor ca 125","description":"Immunoassay for tumor antigen, quantitative; ca 125","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23470","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; hemiarthroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81164","name":"Brca1&2 gen ful dup/del alys","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0106T","name":"Touch quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using touch pressure stimuli to assess large diameter sensation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33016","name":"Pericardiocentesis w/imaging","description":"Pericardiocentesis, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11982.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0147","name":"Scr c/v cyto, automated sys","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36015","name":"Place catheter in artery","description":"Selective catheter placement, segmental or subsegmental pulmonary artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43118","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26700","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52281","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15273","name":"Skin sub grft t/arm/lg child","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474T","name":"Insj aqueous drg dev io rsvr","description":"Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35693","name":"Art trnsposj subclavian","description":"Transposition and/or reimplantation; vertebral to subclavian artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95148","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 4 single stinging insect venoms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27091","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90810","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53415","name":"Reconstruction of urethra","description":"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31786","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","name":"Anes iper upr abd prtl hptc","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64783","name":"Limb nerve surgery add-on","description":"Excision of neuroma; hand or foot, each additional nerve, except same digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96446","name":"Chemotx admn pertl cav impl","description":"Chemotherapy administration into the peritoneal cavity via implanted port or catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37222","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11604","name":"Exc tr-ext mal+marg 3.1-4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23180","name":"Prtl excision bone clavicle","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15220","name":"Fth/gft fr s/a/l 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45387","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64910","name":"Nerve repair w/allograft","description":"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2244.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93294","name":"Rem interrog evl pm/ldls pm","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94720","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43217","name":"Esophagoscopy snare les remv","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61500","name":"Crnec exc tum/bone les skull","description":"Craniectomy; with excision of tumor or other bone lesion of skull","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33522","name":"Cabg artery-vein five","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29800","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G9485","name":"Remote e/m new pt 60mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31296","name":"Nsl/sins ndsc surg frnt sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58180","name":"Partial hysterectomy","description":"Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42821","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; age 12 or over","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19324","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0433","name":"Elisa hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9537","name":"Tc99m mebrofenin","description":"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21194","name":"Reconst lwr jaw w/graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; with bone graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86617","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunoblot)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69710","name":"Implant/replace hearing aid","description":"Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43327","name":"Esoph fundoplasty lap","description":"Esophagogastric fundoplasty partial or complete; laparotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36476","name":"Endovenous rf vein add-on","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53605","name":"Dilate urethra stricture","description":"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S0191","name":"Misoprostol, oral, 200 mcg","description":"Misoprostol, oral, 200 mcg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42508","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63200","name":"Release spinal cord lumbar","description":"Laminectomy, with release of tethered spinal cord, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15771.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34702","name":"Evasc rpr a-ao ndgft rpt","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15787","name":"Abrasion lesions add-on","description":"Abrasion; each additional 4 lesions or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99334","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80103","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43850","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0288","name":"Recon, cta for surg plan","description":"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91313","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43831","name":"Gastrostomy open neonatal","description":"Gastrostomy, open; neonatal, for feeding","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420T","name":"Dstrj neurofibroma xtnsv","description":"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities, extensive, greater than 100 neurofibromas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21295","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99339","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64834","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; hand or foot, common sensory nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21920","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21044","name":"Removal of jaw bone lesion","description":"Excision of malignant tumor of mandible;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40805","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11423","name":"Exc h-f-nk-sp b9+marg 2.1-3","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85421","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33945","name":"Transplantation of heart","description":"Heart transplant, with or without recipient cardiectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43235","name":"Egd diagnostic brush wash","description":"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99486","name":"Suprv interfac trnsport addl","description":"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data inter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87502","name":"Influenza dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, for multiple types or sub-types, includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, first 2 types or sub-types","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45108","name":"Anorectal myomectomy","description":"Anorectal myomectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22632","name":"Arthrd pst tq 1ntrspc lm ea","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24153","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28307","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31527","name":"Laryngoscopy for treatment","description":"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37203","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108243.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67113","name":"Repair retinal detach cplx","description":"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage c-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamp","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4543","name":"Adult disp brief/diap abv xl","description":"Adult sized disposable incontinence product, protective brief/diaper, above extra large, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484T","name":"Tmvi transthoracic exposure","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51565","name":"Revise bladder & ureter(s)","description":"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12014","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28289","name":"Corrj halux rigdus w/o implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47136","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25265","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H2018","name":"Psysoc rehab svc, per diem","description":"Psychosocial rehabilitation services, per diem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49900","name":"Repair of abdominal wall","description":"Suture, secondary, of abdominal wall for evisceration or dehiscence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92371","name":"Rpr&refit spct prsth aphakia","description":"Repair and refitting spectacles; spectacle prosthesis for aphakia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63103","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment (list separately in addition to code for primary proc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50815","name":"Urine shunt to intestine","description":"Ureterocolon conduit, including intestine anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64435","name":"Njx aa&/strd paracrv nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29010","name":"Appl risser jacket body only","description":"Application of risser jacket, localizer, body; only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64716","name":"Revision of cranial nerve","description":"Neuroplasty and/or transposition; cranial nerve (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27705","name":"Osteotomy tibia","description":"Osteotomy; tibia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35485","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99245","name":"Off/op consltj new/est hi 55","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26910","name":"Amputate metacarpal bone","description":"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58958","name":"Resc recr ovr tbl pp utr mal","description":"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy and limited para-aortic lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84302","name":"Assay of sweat sodium","description":"Sodium; other source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95836","name":"Ecog impltd brn npgt <30 d","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter, including recording, with interpretation and written report, up to 30 days","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7523","name":"Tracheostomy shower protect","description":"Tracheostomy shower protector, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85246","name":"Clot factor viii vw antigen","description":"Clotting; factor viii, vw factor antigen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87528","name":"Hsv dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35525","name":"Art byp grft brachial-brchl","description":"Bypass graft, with vein; brachial-brachial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35211","name":"Rpr blvsl dir ntrathrc w/byp","description":"Repair blood vessel, direct; intrathoracic, with bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54865","name":"Explore epididymis","description":"Exploration of epididymis, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24145","name":"Prtl exc bone radial h/n","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), radial head or neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43510","name":"Surgical opening of stomach","description":"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, celestin or mousseaux-barbin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54450","name":"Preputial stretching","description":"Foreskin manipulation including lysis of preputial adhesions and stretching","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65270","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65275","name":"Repair of eye wound","description":"Repair of laceration; cornea, nonperforating, with or without removal foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22852","name":"Remove spine fixation device","description":"Removal of posterior segmental instrumentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0014","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; ambulatory detoxification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87482","name":"Candida dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81443","name":"Genetic tstg severe inh cond","description":"Genetic testing for severe inherited conditions (eg, cystic fibrosis, ashkenazi jewish-associated disorders [eg, bloom syndrome, canavan disease, fanconi anemia type c, mucolipidosis type vi, gaucher disease, tay-sachs disease], beta hemoglobinopathies, phenylketonuria, galactosemia), genomic sequen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56632","name":"Vlvctmy rad prtl bi lymphad","description":"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99340","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15630","name":"Delay flap eye/nos/ear/lip","description":"Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89225","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0236T","name":"Trluml perip athrc abd aorta","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; abdominal aorta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38520","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"13150","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58960","name":"Exploration of abdomen","description":"Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90808","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21088","name":"Impres&prep facial prosth","description":"Impression and custom preparation; facial prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4778.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61700","name":"Brain aneurysm repr simple","description":"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33263","name":"Rmvl & rplcmt dfb gen 2 lead","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21046","name":"Remove mandible cyst complex","description":"Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94004","name":"Vent mgmt nf per day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; nursing facility, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5000","name":"Parenteral sol renal-amirosy","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-premix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35572","name":"Harvest femoropopliteal vein","description":"Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78434","name":"Aqmbf pet rest & rx stress","description":"Absolute quantitation of myocardial blood flow (aqmbf), positron emission tomography (pet), rest and pharmacologic stress (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37251","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99377","name":"Hospice care supervision","description":"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3827.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0247","name":"Trans bench w/wo comm open","description":"Transfer bench for tub or toilet with or without commode opening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51525","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49020","name":"Drainage abdom abscess open","description":"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63270","name":"Excise intrspinl lesion crvl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4178","name":"Parenteral sol amino acid >","description":"Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63662","name":"Remove spine eltrd plate","description":"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1017.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50970","name":"Ureter endoscopy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31626","name":"Bronchoscopy w/markers","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8460","name":"Camisole post-mast","description":"Camisole, post-mastectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21400","name":"Closed tx orbit w/o manipulj","description":"Closed treatment of fracture of orbit, except blowout; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52235","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0460","name":"Autolog prp not diab ulcer","description":"Autologous platelet rich plasma or other blood-derived product for non-diabetic chronic wounds/ulcers, including as applicable phlebotomy, centrifugation or mixing, and all other preparatory procedures, administration and dressings, per treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54416","name":"Remv/repl penis contain pros","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50391","name":"Instll rx agnt into rnal tub","description":"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26746","name":"Treat finger fracture each","description":"Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4648","name":"Implantable tissue marker","description":"Tissue marker, implantable, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45170","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5010","name":"Assessment for hearing aid","description":"Assessment for hearing aid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20702","name":"Mnl prep&insj imed rx dev","description":"Manual preparation and insertion of drug-delivery device(s), intramedullary (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86708","name":"Hepatitis a antibody","description":"Hepatitis a antibody (haab)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87485","name":"Chlmyd pneum dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11641","name":"Exc f/e/e/n/l mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33783","name":"Nikaidoh proc w/ostia implt","description":"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, nikaidoh procedure); with reimplantation of 1 or both coronary ostia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67500","name":"Inject/treat eye socket","description":"Retrobulbar injection; medication (separate procedure, does not include supply of medication)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33285","name":"Insj subq car rhythm mntr","description":"Insertion, subcutaneous cardiac rhythm monitor, including programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27360","name":"Partial removal leg bone(s)","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24357","name":"Repair elbow perc","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67911","name":"Revise eyelid defect","description":"Correction of lid retraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95982","name":"Io ga n-stim subsq w/reprog","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35122","name":"Repair artery rupture belly","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60271","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; cervical approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21470","name":"Optx complicated mndblr fx","description":"Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33474","name":"Revision of pulmonary valve","description":"Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87301","name":"Adenovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; adenovirus enteric types 40/41","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4090.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27516","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15950","name":"Exc trchntr pr ulc prim sutr","description":"Excision, trochanteric pressure ulcer, with primary suture;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24587","name":"Optx partclr fx&/dslc elbw w","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); with implant arthroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33884","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92992","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11719","name":"Trim nail(s) any number","description":"Trimming of nondystrophic nails, any number","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87337","name":"Entamoeb hist group ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica group","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38564","name":"Removal abdomen lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93246","name":"Ext ecg>7d<15d recording","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; recording (includes connection and initial recording)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44345","name":"Revision of colostomy","description":"Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2062","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38214","name":"Volume deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27329","name":"Resect thigh/knee tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26352","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no mans land); secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2313.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80195","name":"Assay of sirolimus","description":"Sirolimus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"68761","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by plug, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93583","name":"Perq transcath septal reduxn","description":"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47425","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4262","name":"Temporary tear duct plug","description":"Temporary, absorbable lacrimal duct implant, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0434","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26502","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48145","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77414","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1874","name":"Stent, coated/cov w/del sys","description":"Stent, coated/covered, with delivery system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40702","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52400","name":"Cysto cgen post urtl valves","description":"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82979","name":"Assay rbc glutathione","description":"Glutathione reductase, rbc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3728.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0277","name":"Hbot, full body chamber, 30m","description":"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23078","name":"Rad rescj tum shoulder 5cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21811","name":"Optx of rib fx w/fixj scope","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99183","name":"Hyperbaric oxygen therapy","description":"Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92933","name":"Prq trlml c athrc st angiop1","description":"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67225","name":"Eye photodynamic ther add-on","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (list separately in addition to code for primary eye treatment)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37231","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88142","name":"Cytopath c/v thin layer","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81178","name":"Atxn1 gene detc abnor allele","description":"Atxn1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82376","name":"Assay carboxyhb qual","description":"Carboxyhemoglobin; qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2039.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5508","name":"Diabetic deluxe shoe","description":"For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87797","name":"Detect agent nos dna dir","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; direct probe technique, each organism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50593","name":"Perc cryo ablate renal tum","description":"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23146","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43756","name":"Dx duod intub w/asp spec","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87527","name":"Hepatitis g dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36261","name":"Revision of infusion pump","description":"Revision of implanted intra-arterial infusion pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53230","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); female","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1885.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97755","name":"Assistive technology assess","description":"Assistive technology assessment (eg, to restore, augment or compensate for existing function, optimize functional tasks and/or maximize environmental accessibility), direct one-on-one contact, with written report, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27350","name":"Removal of kneecap","description":"Patellectomy or hemipatellectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33916","name":"Surgery of great vessel","description":"Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85046","name":"Reticyte/hgb concentrate","description":"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [chr], immature reticulocyte fraction [irf], reticulocyte volume [mrv], rna content), direct measurement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63103","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment (list separately in addition to code for primary proc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99408","name":"Audit/dast 15-30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; 15 to 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6309.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63306","name":"Remov vert idrl bdy thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96154","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["KM","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97129","name":"Ther ivntj 1st 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87220","name":"Tissue exam for fungi","description":"Tissue examination by koh slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4485.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29824","name":"Sho arthrs srg dstl claviclc","description":"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43843","name":"Gstr rstcv oth/thn v-band","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95721","name":"Eeg phy/qhp>36<60 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of eeg recording, without video","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61692","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21356","name":"Opn tx dprsd zygomatic arch","description":"Open treatment of depressed zygomatic arch fracture (eg, gillies approach)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33762","name":"Shunt desc aorta to pulm art","description":"Shunt; descending aorta to pulmonary artery (potts-smith type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31298","name":"Nsl/sins ndsc surg frnt&sphn","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal and sphenoid sinus ostia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27217","name":"Treat pelvic ring fracture","description":"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes pubic symphysis and/or ipsilateral superior/inferior rami)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64892","name":"Nrv grf 1strnd arm/leg <4cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29715","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4097","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"49013","name":"Prpertl pel pack hemrrg trma","description":"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0440","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28208","name":"Repair of foot tendon","description":"Repair, tendon, extensor, foot; primary or secondary, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33983","name":"Replace vad intra w/bp","description":"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2019.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20670","name":"Removal implant superficial","description":"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88175","name":"Cytopath c/v auto fluid redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0141","name":"Scr c/v cyto,autosys and md","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52204","name":"Cystoscopy w/biopsy(s)","description":"Cystourethroscopy, with biopsy(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58548","name":"Lap radical hyst","description":"Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92577","name":"Stenger test speech","description":"Stenger test, speech","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25101","name":"Explore/treat wrist joint","description":"Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62360","name":"Insert spine infusion device","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86804","name":"Hep c ab test confirm","description":"Hepatitis c antibody; confirmatory test (eg, immunoblot)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27326","name":"Neurectomy popliteal","description":"Neurectomy, popliteal (gastrocnemius)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32661","name":"Thoracoscopy w/pericard exc","description":"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49525","name":"Repair ing hernia sliding","description":"Repair inguinal hernia, sliding, any age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58210","name":"Extensive hysterectomy","description":"Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95079","name":"Ingest challenge addl 60 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); each additional 60 minutes of testing (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35889.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43843","name":"Gstr rstcv oth/thn v-band","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical-banded gastroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67923","name":"Repair eyelid defect","description":"Repair of entropion; excision tarsal wedge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28192","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; deep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1887","name":"Catheter, guiding","description":"Catheter, guiding (may include infusion/perfusion capability)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26416","name":"Graft hand or finger tendon","description":"Removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft), hand or finger, each rod","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0313","name":"Immunize couns < 21yr 6-30 m","description":"Immunization counseling by a physician or other qualified health care professional when  the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21387","name":"Opn tx orbit fx combined","description":"Open treatment of orbital floor blowout fracture; combined approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23332","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5069.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25805","name":"Arthrd wrist w/sliding graft","description":"Arthrodesis, wrist; with sliding graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42425","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54560","name":"Exploration for testis","description":"Exploration for undescended testis with abdominal exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26433","name":"Repair finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43458","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77079","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3649","name":"Orthopedic shoe modifica nos","description":"Orthopedic shoe, modification, addition or transfer, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87272","name":"Cryptosporidium ag if","description":"Infectious agent antigen detection by immunofluorescent technique; cryptosporidium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99358","name":"Prolong service w/o contact","description":"Prolonged evaluation and management service before and/or after direct patient care; first hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3241.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96121","name":"Nubhvl xm phy/qhp ea addl hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64445","name":"Njx aa&/strd sciatic nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3339.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95725","name":"Eeg phy/qhp>84 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of eeg recording, without video","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0342","name":"Laparoscopy islet cell trans","description":"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4564.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67930","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11642","name":"Exc f/e/e/n/l mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83937","name":"Assay of osteocalcin","description":"Osteocalcin (bone g1a protein)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28260","name":"Release of midfoot joint","description":"Capsulotomy, midfoot; medial release only (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62147","name":"Crnop w/autograft>5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27086","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; subcutaneous tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1809.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33957","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33745","name":"Tis cgen car anomal 1st shnt","description":"Transcatheter intracardiac shunt (tis) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23412","name":"Repair rotator cuff chronic","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23195","name":"Resection humeral head","description":"Resection, humeral head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2810.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3241.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0091","name":"Obtaining screen pap smear","description":"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35616","name":"Bpg subclavian-axillary","description":"Bypass graft, with other than vein; subclavian-axillary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50542","name":"Laparo ablate renal mass","description":"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95012","name":"Nitric oxide exp gas deter","description":"Nitric oxide expired gas determination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108243.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0408","name":"Inpt/tele follow up 35","description":"Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19361","name":"Brst rcnstj latsms drsi flap","description":"Breast reconstruction; with latissimus dorsi flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51800","name":"Revision of bladder/urethra","description":"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1720.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4224","name":"Parenteral administration ki","description":"Parenteral nutrition administration kit, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57111","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93591","name":"Perq transcath cls aortic","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75993","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33363","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open axillary artery approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83505","name":"Assay total hydroxyproline","description":"Hydroxyproline; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88329","name":"Path consltj drg surg","description":"Pathology consultation during surgery;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29862","name":"Hip arthr0 w/debridement","description":"Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33419","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24538","name":"Prq skel fix sprcndlr hum fx","description":"Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15100","name":"Splt agrft t/a/l 1st 100sqcm","description":"Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52235","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95707","name":"Eeg w/o vid 2-12hr cont mntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"41008","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30130","name":"Excise inferior turbinate","description":"Excision inferior turbinate, partial or complete, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47015","name":"Lapt aspir&/njx hep prst cst","description":"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64895","name":"Nrv grf mltst hnd/foot <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4216","name":"Parenteral nutrition additiv","description":"Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"46614","name":"Anoscopy control bleeding","description":"Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35456","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95940","name":"Ionm in operatng room 15 min","description":"Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75722","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50750","name":"Fusion of ureter & kidney","description":"Ureterocalycostomy, anastomosis of ureter to renal calyx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0761","name":"Nontherm electromgntc device","description":"Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24220","name":"Injection px for elbow arthg","description":"Injection procedure for elbow arthrography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95722","name":"Eeg phy/qhp>36<60 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 36 hours, up to 60 hours of eeg recording, with video (veeg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19001","name":"Puncture aspir cyst brst ea","description":"Puncture aspiration of cyst of breast; each additional cyst (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43240","name":"Egd w/transmural drain cyst","description":"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21050","name":"Removal of jaw joint","description":"Condylectomy, temporomandibular joint (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26765","name":"Treat finger fracture each","description":"Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58823","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34970.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49424","name":"Assess cyst contrast inject","description":"Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38102","name":"Removal of spleen total","description":"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (list in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64890","name":"Nrv grf 1strnd hnd/foot <4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46940","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58292","name":"Vag hyst t/o & repair compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36822","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50075","name":"Nl rmvl lg staghorn calculus","description":"Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5510","name":"Compression form shoe insert","description":"For diabetics only, direct formed, compression molded to patients foot without external heat source, multiple-density insert(s) prefabricated, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66180","name":"Aqueous shunt eye w/graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29887","name":"Arthrs knee srg drlg od fixj","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63056","name":"Decompress spinal cord lmbr","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35761","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78808","name":"Iv inj ra drug dx study","description":"Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid adenoma)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33944","name":"Prepare donor heart","description":"Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left atrium for implantation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87912","name":"Nfct agt gntyp alys hep b","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis b virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49905","name":"Omental flap intra-abdom","description":"Omental flap, intra-abdominal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33781","name":"Rpr tga rcnstj rpr sbpl obst","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with repair of subpulmonic obstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67882","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78464","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11602","name":"Exc tr-ext mal+marg 1.1-2 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51580","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83887","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0216T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22844","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65875","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26255","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35002","name":"Repair artery rupture neck","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, carotid, subclavian artery, by neck incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80172","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69802","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31770","name":"Repair/graft of bronchus","description":"Bronchoplasty; graft repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26670","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81289","name":"Fxn gene known famil variant","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; known familial variant(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33475","name":"Replacement pulmonary valve","description":"Replacement, pulmonary valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54420","name":"Revision of penis","description":"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42140","name":"Excision of uvula","description":"Uvulectomy, excision of uvula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88386","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2523.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27769","name":"Optx post ankle fx","description":"Open treatment of posterior malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24900","name":"Amputation of upper arm","description":"Amputation, arm through humerus; with primary closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33612","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49610","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); first stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55650","name":"Remove sperm duct pouch","description":"Vesiculectomy, any approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67227","name":"Dstrj extensive retinopathy","description":"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99339","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27829","name":"Treat lower leg joint","description":"Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52601","name":"Prostatectomy (turp)","description":"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64561","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22844","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27332","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial or lateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25924","name":"Amputation follow-up surgery","description":"Disarticulation through wrist; re-amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61559","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2193.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35246","name":"Rpr blvsl vn grf ntrthrc w/o","description":"Repair blood vessel with vein graft; intrathoracic, without bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26596","name":"Excision constricting tissue","description":"Excision of constricting ring of finger, with multiple z-plasties","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17855.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92225","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11426","name":"Exc h-f-nk-sp b9+marg >4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99375","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12331.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54130","name":"Remove penis & nodes","description":"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2318.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60000","name":"I&d thyroglssl dux cst infct","description":"Incision and drainage of thyroglossal duct cyst, infected","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1823.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21501","name":"I&d dp absc/hmtma sft ts nck","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4224.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27654","name":"Repair of achilles tendon","description":"Repair, secondary, achilles tendon, with or without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55706","name":"Bx prst8 ndl sat sampling","description":"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88274","name":"Cytogenetics 25-99","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80051","name":"Electrolyte panel","description":"Electrolyte panel this panel must include the following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99201","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28262","name":"Revision of foot and ankle","description":"Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23184","name":"Prtl excision bone prox hum","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15931","name":"Exc sacral pr ulc prim sutr","description":"Excision, sacral pressure ulcer, with primary suture;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32602","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33861","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4376.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56606","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); each separate additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20102","name":"Expl pentrg wnd abd/flnk/bk","description":"Exploration of penetrating wound (separate procedure); abdomen/flank/back","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86001","name":"Allergen specific igg","description":"Allergen specific igg quantitative or semiquantitative, each allergen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50574","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26434","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; with free graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17004","name":"Destroy premal lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27808","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61458","name":"Crnec sopl xpl/dcmpr crl nrv","description":"Craniectomy, suboccipital; for exploration or decompression of cranial nerves","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50695","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61305","name":"Crnec/crnot expl infratntorl","description":"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99606","name":"Mtms by pharm est 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, established patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15775","name":"Hair trnspl 1-15 punch grfts","description":"Punch graft for hair transplant; 1 to 15 punch grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4495","name":"Thigh length surg stocking","description":"Surgical stockings thigh length, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3202","name":"Oxford w/ supinat/pronator c","description":"Orthopedic shoe, oxford with supinator or pronator, child","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37241","name":"Vasc embolize/occlude venous","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28210","name":"Repair/graft of foot tendon","description":"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33025","name":"Incision of heart sac","description":"Creation of pericardial window or partial resection for drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90863","name":"Pharmacologic mgmt w/psytx","description":"Pharmacologic management, including prescription and review of medication, when performed with psychotherapy services (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"P3000","name":"Screen pap by tech w md supv","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20969","name":"Bone/skin graft microvasc","description":"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64837","name":"Repair nerve add-on","description":"Suture of each additional nerve, hand or foot (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64901","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; single strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0034A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33959","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43652","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"S3835","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64508","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50250","name":"Opn abltj 1/> rnl mas crysrg","description":"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33472","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94667","name":"Mnpj chest wall 1st","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; initial demonstration and/or evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61520","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"57465","name":"Cam cervix uteri drg colp","description":"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87803","name":"Clostridium toxin a w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; clostridium difficile toxin a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20930","name":"Sp bone algrft morsel add-on","description":"Allograft, morselized, or placement of osteopromotive material, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22850","name":"Remove spine fixation device","description":"Removal of posterior nonsegmental instrumentation (eg, harrington rod)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43842","name":"Gstr rstcv px v-banded gstp","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35021","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32601","name":"Thoracoscopy diagnostic","description":"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15756","name":"Free myo/skin flap microvasc","description":"Free muscle or myocutaneous flap with microvascular anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86038","name":"Antinuclear antibodies","description":"Antinuclear antibodies (ana);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42100","name":"Biopsy roof of mouth","description":"Biopsy of palate, uvula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64782","name":"Remove limb nerve lesion","description":"Excision of neuroma; hand or foot, except digital nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15946","name":"Exc isch pr ulc prep mus flp","description":"Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57107","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4224.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0581T","name":"Abltj mal brst tum perq crtx","description":"Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64635","name":"Destroy lumb/sac facet jnt","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, single facet joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25035","name":"Inc dp bone crtx f/arm&/wrst","description":"Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35535","name":"Art byp grft hepatorenal","description":"Bypass graft, with vein; hepatorenal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99186","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62005","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; compound or comminuted, extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27220","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54328","name":"Revise penis/urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87590","name":"N.gonorrhoeae dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1610.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27185","name":"Revision of femur epiphysis","description":"Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64897","name":"Nrv grf mltst arm/leg <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25151","name":"Partial removal of radius","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26410","name":"Repair hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69970","name":"Remove inner ear lesion","description":"Removal of tumor, temporal bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36600","name":"Withdrawal of arterial blood","description":"Arterial puncture, withdrawal of blood for diagnosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2317.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46760","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; muscle transplant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61253","name":"Burr hole treph ittl uni/bi","description":"Burr hole(s) or trephine, infratentorial, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27091","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93563","name":"Njx cgen car cth slctv c ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63610","name":"Stimulation of spinal cord","description":"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54336","name":"Revise penis/urethra","description":"1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20703","name":"Rmvl imed rx delivery device","description":"Removal of drug-delivery device(s), intramedullary (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12767.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85612","name":"Viper venom prothrombin time","description":"Russell viper venom time (includes venom); undiluted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92532","name":"Positional nystagmus test","description":"Positional nystagmus test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57555","name":"Remove cervix/repair vagina","description":"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99188","name":"App topical fluoride varnish","description":"Application of topical fluoride varnish by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1843.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68801.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65772","name":"Correction of astigmatism","description":"Corneal relaxing incision for correction of surgically induced astigmatism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93702","name":"Bis xtracell fluid analysis","description":"Bioimpedance spectroscopy (bis), extracellular fluid analysis for lymphedema assessment(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37208","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84078","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline; heat stable (total not included)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69155","name":"Extensive ear/neck surgery","description":"Radical excision external auditory canal lesion; with neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26160","name":"Remove tendon sheath lesion","description":"Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4538","name":"Diaper serv reusable diaper","description":"Diaper service, reusable diaper, each diaper","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26952","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (v-y, hood)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20220","name":"Bone biopsy trocar/ndl supfc","description":"Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80503","name":"Path clin consltj sf 5-20","description":"Pathology clinical consultation; for a clinical problem, with limited review of patients history and medical records and straightforward medical decision making when using time for code selection, 5-20 minutes of total time is spent on the date of the consultation.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87526","name":"Hepatitis g dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25609","name":"Optx dst rd xart fx/ep sep3+","description":"Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27120","name":"Reconstruction of hip socket","description":"Acetabuloplasty; (eg, whitman, colonna, haygroves, or cup type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27591","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; immediate fitting technique including first cast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43754","name":"Dx gastr intub w/asp spec","description":"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1876","name":"Stent, non-coa/non-cov w/del","description":"Stent, non-coated/non-covered, with delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24470","name":"Hemiepiphyseal arrest","description":"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82492","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35456","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3208.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96020","name":"Functional brain mapping","description":"Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or other qualified health care professional (ie, psychologist), with review of test results and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61782","name":"Scan proc cranial extra","description":"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1610.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83071","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54057","name":"Laser surg penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0307","name":"Cbc without platelet","description":"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21260","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46938","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21601","name":"Exc chest wall tumor w/ribs","description":"Excision of chest wall tumor including rib(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46612","name":"Anoscopy remove lesions","description":"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29581","name":"Appl multlayer cmprn sys leg","description":"Application of multi-layer compression system; leg (below knee), including ankle and foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82145","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0124","name":"Screen c/v thin layer by md","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35508","name":"Art byp grft carotid-vertbrl","description":"Bypass graft, with vein; carotid-vertebral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98942","name":"Chiropractic manj 5 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 5 regions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8914","name":"Mra w/o fol w/cont, lwr ext","description":"Magnetic resonance angiography without contrast followed by with contrast, lower extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92015","name":"Determine refractive state","description":"Determination of refractive state","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93654","name":"Compre ep eval tx vt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22110","name":"Remove part of neck vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28262","name":"Revision of foot and ankle","description":"Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and tendon(s) lengthening (eg, resistant clubfoot deformity)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5100.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64483","name":"Njx aa&/strd tfrm epi l/s 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63040","name":"Laminotomy single cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2246.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0031A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61595","name":"Transtemporal approach/skull","description":"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27427","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; extra-articular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87147","name":"Culture type immunologic","description":"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33641","name":"Repair heart septum defect","description":"Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25608","name":"Optx dst rd xart fx/epi sep2","description":"Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24110","name":"Exc/curtg b1 cst/b9 tum hum","description":"Excision or curettage of bone cyst or benign tumor, humerus;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"27076","name":"Resect hip tum incl acetabul","description":"Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65105","name":"Remove eye/attach implant","description":"Enucleation of eye; with implant, muscles attached to implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50434","name":"Convert nephrostomy catheter","description":"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4083","name":"Enteral stomach tube levine","description":"Stomach tube - levine type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44604","name":"Suture large intestine","description":"Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture (single or multiple perforations); without colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95060","name":"Oph mucous membrane tests","description":"Ophthalmic mucous membrane tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86753","name":"Protozoa antibody nos","description":"Antibody; protozoa, not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2842.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34804","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93788","name":"Ambl bp mntr w/sw a/r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; scanning analysis with report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3942.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61863","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22554","name":"Arthrd ant ntrbd min dsc crv","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below c2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33366","name":"Trcath replace aortic valve","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transapical exposure (eg, left thoracotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57023","name":"I&d vaginal hematoma non-ob","description":"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86185","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37188","name":"Ven mechnl thrmbc repeat tx","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49010","name":"Exploration behind abdomen","description":"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37203","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61571","name":"Incise skull for brain wound","description":"Craniectomy or craniotomy; with treatment of penetrating wound of brain","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0079","name":"Care manag h vst new pt 60 m","description":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64446","name":"Njx aa&/strd sc nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29000","name":"Appl halo type body cast","description":"Application of halo type body cast (see 20661-20663 for insertion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43772","name":"Lap rmvl gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22521","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85598","name":"Hexagnal phosph pltlt neutrl","description":"Phospholipid neutralization; hexagonal phospholipid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92924","name":"Prq trluml c athrc 1 art&/br","description":"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64413","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33282","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38747","name":"Remove abdominal lymph nodes","description":"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83625","name":"Assay of ldh enzymes","description":"Lactate dehydrogenase (ld), (ldh); isoenzymes, separation and quantitation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35022","name":"Repair artery rupture chest","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67039","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37565","name":"Ligation int jugular vein","description":"Ligation, internal jugular vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3744.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45113","name":"Partial proctectomy","description":"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (s or j), with or without loop ileostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93542","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82690","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61697","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3926.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33340","name":"Perq clsr tcat l atr apndge","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84238","name":"Assay nonendocrine receptor","description":"Receptor assay; non-endocrine (specify receptor)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86644","name":"Cmv antibody","description":"Antibody; cytomegalovirus (cmv)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65235","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from anterior chamber of eye or lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39540","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59871","name":"Remove cerclage suture","description":"Removal of cerclage suture under anesthesia (other than local)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0150T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81173","name":"Ar gene full gene sequence","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; full gene sequence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86226","name":"Dna antibody single strand","description":"Deoxyribonucleic acid (dna) antibody; single stranded","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31051","name":"Sphenoid sinus surgery","description":"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27132","name":"Total hip arthroplasty","description":"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0277","name":"Hbot, full body chamber, 30m","description":"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52204","name":"Cystoscopy w/biopsy(s)","description":"Cystourethroscopy, with biopsy(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64821","name":"Sympathectomy radial artery","description":"Sympathectomy; radial artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36252","name":"Ins cath ren art 1st bilat","description":"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and inte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26498","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; all 4 fingers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78591","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31584","name":"Laryngoplasty fx rdctj fixj","description":"Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12032","name":"Intmd rpr s/a/t/ext 2.6-7.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"14040","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21390","name":"Opn tx orbit periorbtl implt","description":"Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47147","name":"Prep donor liver/arterial","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42825","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; younger than age 12","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82172","name":"Assay of apolipoprotein","description":"Apolipoprotein, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33877","name":"Thoracoabdominal graft","description":"Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3184.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61606","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66982","name":"Xcapsl ctrc rmvl cplx wo ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43330","name":"Esophagomyotomy abdominal","description":"Esophagomyotomy (heller type); abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49440","name":"Place gastrostomy tube perc","description":"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44121","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0355T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47382","name":"Percut ablate liver rf","description":"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4244","name":"Alcohol or peroxide per pint","description":"Alcohol or peroxide, per pint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2295.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11012","name":"Deb skin bone at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35490","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11603","name":"Exc tr-ext mal+marg 2.1-3 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21245","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17463.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21812","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89230","name":"Collect sweat for test","description":"Sweat collection by iontophoresis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3223.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96153","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7792.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64491","name":"Inj paravert f jnt c/t 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4350.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2250","name":"Remot img sub by pt, non e/m","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or p","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29907","name":"Subtalar arthro w/fusion","description":"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44020","name":"Explore small intestine","description":"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96523","name":"Irrig drug delivery device","description":"Irrigation of implanted venous access device for drug delivery systems","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87912","name":"Nfct agt gntyp alys hep b","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hepatitis b virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01180","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"12013","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99454","name":"Rem mntr physiol param 16-30","description":"Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate); device(s) supply with daily recording(s) or programmed alert(s) transmission, 16-30 days in a 30-day period","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49614","name":"Rpr aa hrn rcr < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46924","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3142.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67908","name":"Repair eyelid defect","description":"Repair of blepharoptosis; conjunctivo-tarso-mullers muscle-levator resection (eg, fasanella-servat type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0505","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51580","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99149","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15821","name":"Blepharp lwr eyelid fat pad","description":"Blepharoplasty, lower eyelid; with extensive herniated fat pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87905","name":"Ia nzmtc actv oth/thn virus","description":"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93653","name":"Compre ep eval tx svt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32604","name":"Thoracoscopy wbx sac","description":"Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62311","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82746","name":"Assay of folic acid serum","description":"Folic acid; serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42820","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; younger than age 12","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01682","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67400","name":"Explore/biopsy eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99174","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50694","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86378","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37239","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35626","name":"Bpg aor-subcla/innom/carotid","description":"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58550","name":"Laparo-asst vag hysterectomy","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25100","name":"Biopsy of wrist joint","description":"Arthrotomy, wrist joint; with biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28088","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; extensor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22808","name":"Arthrd ant dfrm 2-3 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35883","name":"Revj fem anast nonautog grf","description":"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with nonautogenous patch graft (eg, polyester, eptfe, bovine pericardium)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21813","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92311","name":"Contact lens fitg aphakia 1","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, 1 eye","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69554","name":"Exc aurl glomus tum extended","description":"Excision aural glomus tumor; extended (extratemporal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51590","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92621","name":"Auditory function + 15 min","description":"Evaluation of central auditory function, with report; each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9041","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62142","name":"Rmvl b1 flp/prostc plate skl","description":"Removal of bone flap or prosthetic plate of skull","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36903","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26686","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6405.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82649","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43123","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26420","name":"Repair/graft finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2013","name":"Post-d/c h vst ext pt 75 m","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient fa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0102","name":"Prostate ca screening; dre","description":"Prostate cancer screening; digital rectal examination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24079","name":"Rad rescj tum tiss a/e 5 cm+","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22869","name":"Insj stablj dev w/o dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"C1788","name":"Port, indwelling, imp","description":"Port, indwelling (implantable)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33215","name":"Reposition pacing-defib lead","description":"Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33777","name":"Rpr tga bfl rpr sbpulm obstr","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with repair of subpulmonic obstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25420","name":"Repair/graft radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21049","name":"Excis uppr jaw cyst w/repair","description":"Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64642","name":"Chemodenerv 1 extremity 1-4","description":"Chemodenervation of one extremity; 1-4 muscle(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80434","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for acth insufficiency this panel must include the following: cortisol (82533 x 5) glucose (82947 x 5)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34834","name":"Opn brach art expos","description":"Open brachial artery exposure for delivery of endovascular prosthesis, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22853","name":"Insj biomechanical device","description":"Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (list separately in addition to code fo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61543","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28312","name":"Revision of toe","description":"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5194.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21740","name":"Reconstruction of sternum","description":"Reconstructive repair of pectus excavatum or carinatum; open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1662.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45560","name":"Repair of rectocele","description":"Repair of rectocele (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5454.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95970","name":"Alys npgt w/o prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26502","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45563","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury; with colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88740","name":"Transcutaneous carboxyhb","description":"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32505","name":"Wedge resect of lung initial","description":"Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4707","name":"Bicarbonate conc pow per pac","description":"Bicarbonate concentrate, powder, for hemodialysis, per packet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21179","name":"Rcnstj forehead with grafts","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84583","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; semiquantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22630","name":"Arthrd pst tq 1ntrspc lum","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32491","name":"Lung volume reduction","description":"Removal of lung, other than pneumonectomy; with resection-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, includes any pleural procedure, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84315","name":"Body fluid specific gravity","description":"Specific gravity (except urine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63620","name":"Srs spinal lesion","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36561","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87529","name":"Hsv dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4531","name":"Ped size pull-on sm/med","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22525","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95852","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); hand, with or without comparison with normal side","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86711","name":"John cunningham antibody","description":"Antibody; jc (john cunningham) virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54415","name":"Remove self-contd penis pros","description":"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2004","name":"Post-d/c h vst new pt 60 m","description":"Comprehensive (60 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient faci","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38900","name":"Io map of sent lymph node","description":"Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3672","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27659","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26200","name":"Remove hand bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99148","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33957","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35005","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65270","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27325","name":"Neurectomy hamstring","description":"Neurectomy, hamstring muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92608","name":"Ex for speech device rx addl","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33863","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (eg, bentall)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80307","name":"Drug test prsmv chem anlyzr","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay [eg, eia, elisa, emit, fpia, ia, kims, ria]), chromatography (eg, gc, hplc), and mass spectrometry either with or without chromatography, (eg, dart","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35536","name":"Art byp grft splenorenal","description":"Bypass graft, with vein; splenorenal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83670","name":"Assay of lap enzyme","description":"Leucine aminopeptidase (lap)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26035","name":"Decompress fingers/hand","description":"Decompression fingers and/or hand, injection injury (eg, grease gun)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92620","name":"Auditory function 60 min","description":"Evaluation of central auditory function, with report; initial 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99153","name":"Mod sed same phys/qhp ea","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15836","name":"Exc excessive skin arm","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25426","name":"Repair/graft radius & ulna","description":"Repair of defect with autograft; radius and ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33884","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44408","name":"Colonoscopy w/decompression","description":"Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24105","name":"Excision olecranon bursa","description":"Excision, olecranon bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21555","name":"Exc neck les sc < 3 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3179.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64408","name":"Njx aa&/strd vagus nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26055","name":"Incise finger tendon sheath","description":"Tendon sheath incision (eg, for trigger finger)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4652","name":"Microcapillary tube sealant","description":"Microcapillary tube sealant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37718","name":"Lig div&strpg short saph vn","description":"Ligation, division, and stripping, short saphenous vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89325","name":"Sperm antibody test","description":"Sperm antibodies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92370","name":"Rpr&refitg spect xcp aphakia","description":"Repair and refitting spectacles; except for aphakia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41006","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96425","name":"Chemotherapy infusion method","description":"Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23406","name":"Incise tendon(s) & muscle(s)","description":"Tenotomy, shoulder area; multiple tendons through same incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93798","name":"Phys/qhp op car rhab w/ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; with continuous ecg monitoring (per session)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21390","name":"Opn tx orbit periorbtl implt","description":"Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25109","name":"Excise tendon forearm/wrist","description":"Excision of tendon, forearm and/or wrist, flexor or extensor, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67042","name":"Vit for macular hole","description":"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46946","name":"Int hrhc lig 2+hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30905","name":"Control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51940","name":"Correction of bladder defect","description":"Closure, exstrophy of bladder","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0248T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20697","name":"App mltpln uni xtrnl fix xch","description":"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36573","name":"Insj picc rs&i 5 yr+","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; age 5 years or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83921","name":"Organic acid single quant","description":"Organic acid, single, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96416","name":"Chemo prolong infuse w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22869","name":"Insj stablj dev w/o dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55815","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36904","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25391","name":"Lengthen radius or ulna","description":"Osteoplasty, radius or ulna; lengthening with autograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21320","name":"Clsd tx nsl fx w/mnpj&stablj","description":"Closed treatment of nasal bone fracture with manipulation; with stabilization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81182","name":"Atxn8os gen detc abnor allel","description":"Atxn8os (atxn8 opposite strand [non-protein coding]) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65125","name":"Revise ocular implant","description":"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81163","name":"Brca1&2 gene full seq alys","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31292","name":"Nsl/sins ndsc med/inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2187.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23395","name":"Muscle transfer shoulder/arm","description":"Muscle transfer, any type, shoulder or upper arm; single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53460","name":"Revision of urethra","description":"Urethromeatoplasty, with partial excision of distal urethral segment (richardson type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17273","name":"Dstr mal les s/n/h/f/g 2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43640","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28740","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, single joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85397","name":"Clotting funct activity","description":"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, adamts-13), each analyte","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2082","name":"Visit esketamine 56m or less","description":"Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of up to 56 mg of esketamine nasal self-administration, includes 2 hours post-administration observation","date_of_service":"2026-06-06","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","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35221","name":"Rpr bld vsl dir intra-abdl","description":"Repair blood vessel, direct; intra-abdominal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97112","name":"Neuromuscular reeducation","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47785","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of intrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2726.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4266","name":"Diaphragm","description":"Diaphragm for contraceptive use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87651","name":"Strep a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35585","name":"Vein byp fem-tibial peroneal","description":"In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54348","name":"Rpr hypspad comp dsj & urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21150","name":"Rcnstj mdfc lefrtii ant ntru","description":"Reconstruction midface, lefort ii; anterior intrusion (eg, treacher-collins syndrome)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76880","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17463.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3049.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43124","name":"Removal of esophagus","description":"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31725","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37606","name":"Lig int/com carotid art occl","description":"Ligation; internal or common carotid artery, with gradual occlusion, as with selverstone or crutchfield clamp","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35666","name":"Bpg fem-ant tib pst tib/prnl","description":"Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46700","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; adult","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47480","name":"Incision of gallbladder","description":"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2826.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67901","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9612","name":"Catheterize for urine spec","description":"Catheterization for collection of specimen, single patient, all places of service","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26498","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; all 4 fingers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52400","name":"Cysto cgen post urtl valves","description":"Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61548","name":"Removal of pituitary gland","description":"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24635","name":"Optx monteggia fx dislc elbw","description":"Open treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2411.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4918","name":"Venous pressure clamp","description":"Venous pressure clamp, for hemodialysis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21556","name":"Exc neck tum deep < 5 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82286","name":"Assay of bradykinin","description":"Bradykinin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94668","name":"Mnpj chest wall sbsq","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44372","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82978","name":"Assay of glutathione","description":"Glutathione","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20605","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0184T","name":"Exc rectal tumor endoscopic","description":"Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, tems), including muscularis propria (ie, full thickness)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43337","name":"Thorabd diaphr hern repair","description":"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49617","name":"Rpr aa hrn rcr > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35506","name":"Art byp grft subclav-carotid","description":"Bypass graft, with vein; carotid-subclavian or subclavian-carotid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45337","name":"Sigmoidoscopy & decompress","description":"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0420T","name":"Dstrj neurofibroma xtnsv","description":"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); trunk and extremities, extensive, greater than 100 neurofibromas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27049","name":"Resect hip/pelv tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95146","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 2 single stinging insect venoms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63273","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85290","name":"Clot factor xiii fibrin stab","description":"Clotting; factor xiii (fibrin stabilizing)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27334","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior or posterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60281","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus; recurrent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45121","name":"Removal of rectum and colon","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with subtotal or total colectomy, with multiple biopsies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1462.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63704","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; less than 5 cm diameter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44322","name":"Colostomy with biopsies","description":"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50329","name":"Prep renal graft/ureteral","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0248","name":"Hdtrans bench w/wo comm open","description":"Transfer bench, heavy duty, for tub or toilet with or without commode opening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35511","name":"Art byp grft subclav-subclav","description":"Bypass graft, with vein; subclavian-subclavian","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33778","name":"Rpr tga aortic pulm art rcns","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2045.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0603","name":"Electric breast pump","description":"Breast pump, electric (ac and/or dc), any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33982","name":"Replace vad intra w/o bp","description":"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86486","name":"Skin test unlisted antign ea","description":"Skin test; unlisted antigen, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52344","name":"Cysto/uretero stricture tx","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56442","name":"Hymenotomy","description":"Hymenotomy, simple incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63706","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; larger than 5 cm diameter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43336","name":"Thorabd diaphr hern repair","description":"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1998.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61055","name":"Injection into brain canal","description":"Cisternal or lateral cervical (c1-c2) puncture; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27530","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4226.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33775","name":"Rpr tga atr bfl rmvl plm bnd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with removal of pulmonary band","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0403T","name":"Diabetes prev standard curr","description":"Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88148","name":"Cytopath c/v auto rescreen","description":"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54535","name":"Extensive testis surgery","description":"Orchiectomy, radical, for tumor; with abdominal exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87472","name":"Bartonella dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67043","name":"Vit for membrane dissect","description":"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and laser photocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22818","name":"Kyphectomy 1-2 segments","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5012.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99424","name":"Prin care mgmt phys 1st 30","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23335","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total shoulder)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4668.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28193","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0208T","name":"Audiometry air only","description":"Pure tone audiometry (threshold), automated; air only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38208","name":"Thaw preserved stem cells","description":"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95134","name":"Immntx 5 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 5 stinging insect venoms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83891","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62303","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45905","name":"Dilation of anal sphincter","description":"Dilation of anal sphincter (separate procedure) under anesthesia other than local","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24120","name":"Exc/crtg b1 cst/b9 tum rds","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61868","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; each additional ar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50955","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45172","name":"Exc rect tum transanal full","description":"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0191T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4268","name":"Female condom","description":"Contraceptive supply, condom, female, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76880","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9016","name":"Rbc leukocytes reduced","description":"Red blood cells, leukocytes reduced, each unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37247","name":"Trluml balo angiop addl art","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65420","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19535.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27303","name":"Drainage of bone lesion","description":"Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3835","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45320","name":"Proctosigmoidoscopy ablate","description":"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14020","name":"Tis trnfr s/a/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52345","name":"Cysto/uretero w/up stricture","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86891","name":"Autologous blood op salvage","description":"Autologous blood or component, collection processing and storage; intra- or postoperative salvage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1610.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10028.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4522","name":"Adult size brief/diaper med","description":"Adult sized disposable incontinence product, brief/diaper, medium, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0481","name":"Drug test def 8-14 classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67112","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82488","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27030","name":"Arthrotomy hip w/drainage","description":"Arthrotomy, hip, with drainage (eg, infection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27125","name":"Partial hip replacement","description":"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61867","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92984","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21079","name":"Impres&prep intrm obt prosth","description":"Impression and custom preparation; interim obturator prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36247","name":"Ins cath abd/l-ext art 3rd","description":"Selective catheter placement, arterial system; initial third order or more selective abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87265","name":"Pertussis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; bordetella pertussis/parapertussis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34842","name":"Endovasc visc aorta 2 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25440","name":"Repair nonu scphd carpl b1","description":"Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82107","name":"Alpha-fetoprotein l3","description":"Alpha-fetoprotein (afp); afp-l3 fraction isoform and total afp (including ratio)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23520","name":"Cltx strnclav dislc w/o mnpj","description":"Closed treatment of sternoclavicular dislocation; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20604","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41825","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43855","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25275","name":"Repair forearm tendon sheath","description":"Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27156","name":"Revision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and with open reduction of hip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33206","name":"Insert heart pm atrial","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0123","name":"Screen cerv/vag thin layer","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54300","name":"Revision of penis","description":"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23030","name":"I&d shoulder deep absc/hmtma","description":"Incision and drainage, shoulder area; deep abscess or hematoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50551","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25505","name":"Cltx rdl shft fx w/mnpj","description":"Closed treatment of radial shaft fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41018","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90822","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42830","name":"Removal of adenoids","description":"Adenoidectomy, primary; younger than age 12","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33779","name":"Rpr tga rcnstj rmvl plm bnd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with removal of pulmonary band","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14041","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33512","name":"Cabg vein three","description":"Coronary artery bypass, vein only; 3 coronary venous grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78584","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67031","name":"Laser surgery eye strands","description":"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62141","name":"Crnop skull defect>5 cm diam","description":"Cranioplasty for skull defect; larger than 5 cm diameter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19305","name":"Mast radical","description":"Mastectomy, radical, including pectoral muscles, axillary lymph nodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38700","name":"Removal of lymph nodes neck","description":"Suprahyoid lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98940","name":"Chiropract manj 1-2 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 1-2 regions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22325","name":"Treat spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65110","name":"Removal of eye","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38100","name":"Removal of spleen total","description":"Splenectomy; total (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27065","name":"Remove hip bone les super","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0165T","name":"Revise lumb artif disc addl","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61055","name":"Injection into brain canal","description":"Cisternal or lateral cervical (c1-c2) puncture; with injection of medication or other substance for diagnosis or treatment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50930","name":"Closure ureter/bowel fistula","description":"Closure of ureterovisceral fistula (including visceral repair)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67801","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, same lid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44407","name":"Colonoscopy w/ndl aspir/bx","description":"Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3530.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54692","name":"Laparoscopy orchiopexy","description":"Laparoscopy, surgical; orchiopexy for intra-abdominal testis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80306","name":"Drug test prsmv instrmnt","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36221","name":"Place cath thoracic aorta","description":"Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93590","name":"Perq transcath cls mitral","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61567","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2349.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27881","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90863","name":"Pharmacologic mgmt w/psytx","description":"Pharmacologic management, including prescription and review of medication, when performed with psychotherapy services (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9489","name":"Remote e/m est. pt 40mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision makin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21343","name":"Open tx dprsd front sinus fx","description":"Open treatment of depressed frontal sinus fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84588","name":"Assay of vasopressin","description":"Vasopressin (antidiuretic hormone, adh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15841","name":"Nerve palsy muscle graft","description":"Graft for facial nerve paralysis; free muscle graft (including obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19101","name":"Biopsy of breast open","description":"Biopsy of breast; open, incisional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24301","name":"Musc/tdn transfer upr a/e 1","description":"Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33330","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82705","name":"Fats/lipids feces qual","description":"Fat or lipids, feces; qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4323.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60252","name":"Removal of thyroid","description":"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1116.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4927","name":"Non-sterile gloves","description":"Gloves, non-sterile, per 100","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11040","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49436","name":"Embedded ip cath exit-site","description":"Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15152","name":"Tis cltr skn agrft t/a/l ea","description":"Tissue cultured skin autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81172","name":"Aff2 gen alys charac alleles","description":"Aff2 (alf transcription elongation factor 2 [fmr2]) (eg, fragile x intellectual disability 2 [fraxe]) gene analysis; characterization of alleles (eg, expanded size and methylation status)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27768","name":"Cltx post ankle fx w/mnpj","description":"Closed treatment of posterior malleolus fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34101","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67345","name":"Destroy nerve of eye muscle","description":"Chemodenervation of extraocular muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67113","name":"Repair retinal detach cplx","description":"Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage c-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61619","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis muscle)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27882","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; open, circular (guillotine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27734","name":"Repair lower leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41009","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99239","name":"Hosp ip/obs dschrg mgmt >30","description":"Hospital inpatient or observation discharge day management; more than 30 minutes on the date of the encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58571","name":"Tlh w/t/o 250 g or less","description":"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00561","name":"Anes px heart w/pump<1 yr","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, younger than 1 year of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22614","name":"Arthrd pst tq 1ntrspc ea add","description":"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92227","name":"Img rta detcj/mntr ds staff","description":"Imaging of retina for detection or monitoring of disease; with remote clinical staff review and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84035","name":"Assay of phenylketones","description":"Phenylketones, qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0870","name":"Pwc gp 4 hd seat/back","description":"Power wheelchair, group 4 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83892","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47534","name":"Plmt biliary drainage cath","description":"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; internal-external","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22327","name":"Treat thorax spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0430","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73542","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20693","name":"Adjmt/revj ext fixj sys anes","description":"Adjustment or revision of external fixation system requiring anesthesia (eg, new pin[s] or wire[s] and/or new ring[s] or bar[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43261","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45309","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36225","name":"Place cath subclavian art","description":"Selective catheter placement, subclavian or innominate artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92924","name":"Prq trluml c athrc 1 art&/br","description":"Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54304","name":"Revision of penis","description":"Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58120","name":"Dilation and curettage","description":"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62322","name":"Njx interlaminar lmbr/sac","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95711","name":"Veeg 2-12 hr unmonitored","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; unmonitored","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97810","name":"Acup 1/> wo estim 1st 15 min","description":"Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3370.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27350","name":"Removal of kneecap","description":"Patellectomy or hemipatellectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99364","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4913.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26615","name":"Treat metacarpal fracture","description":"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61616","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; intradural, including dural repair, with or without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24505","name":"Cltx humrl shft fx w/mnpj","description":"Closed treatment of humeral shaft fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19082","name":"Bx breast add lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23650","name":"Cltx sho dslc w/mnpj wo anes","description":"Closed treatment of shoulder dislocation, with manipulation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95830","name":"Insert electrodes for eeg","description":"Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (eeg) recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88738","name":"Hgb quant transcutaneous","description":"Hemoglobin (hgb), quantitative, transcutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19369","name":"Brst rcnstj 2 pdcl tram flap","description":"Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26546","name":"Repair nonunion hand","description":"Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or without external or internal fixation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82485","name":"Assay chondroitin sulfate","description":"Chondroitin b sulfate, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0466T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62290","name":"Njx px discography lumbar","description":"Injection procedure for discography, each level; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1999.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45303","name":"Proctosigmoidoscopy dilate","description":"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92563","name":"Tone decay hearing test","description":"Tone decay test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88152","name":"Cytopath c/v auto redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12331.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33226","name":"Reposition l ventric lead","description":"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59136","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0499T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37765","name":"Stab phleb veins xtr 10-20","description":"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4570","name":"Splint","description":"Splint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87255","name":"Genet virus isolate hsv","description":"Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87811","name":"Sars-cov-2 covid19 w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92937","name":"Prq trluml revsc cab grf 1","description":"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed, single major coronary artery and/or its branches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15004","name":"Wound prep f/n/hf/g","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of bo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9507","name":"In111 capromab","description":"Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60225","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49652","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96904","name":"Whole body photography","description":"Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47900","name":"Suture bile duct injury","description":"Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10006","name":"Fna bx w/us gdn ea addl","description":"Fine needle aspiration biopsy, including ultrasound guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2515.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95071","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3914.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83861","name":"Microfluid analy tears","description":"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32095","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L0210","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22804","name":"Arthrd pst dfrm 13+ vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33504","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53040","name":"Drainage of urethra abscess","description":"Drainage of deep periurethral abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29280","name":"Strapping of hand or finger","description":"Strapping; hand or finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23490","name":"Reinforce clavicle","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62264","name":"Epidural lysis on single day","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84540","name":"Assay of urine/urea-n","description":"Urea nitrogen, urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84022","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99467","name":"Ped crit care transport addl","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44211","name":"Lap colectomy w/proctectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (s or j), with loop ileostomy, includes rectal mucosectomy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63196","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32110","name":"Explore/repair chest","description":"Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83497","name":"Assay of 5-hiaa","description":"Hydroxyindolacetic acid, 5-(hiaa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78586","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31637","name":"Bronchoscopy stent add-on","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15121","name":"Splt agrft f/s/n/h/f/g/m ea","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19110","name":"Nipple exploration","description":"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"15829","name":"Rhytidectomy smas flap","description":"Rhytidectomy; superficial musculoaponeurotic system (smas) flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26756","name":"Pin finger fracture each","description":"Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81181","name":"Atxn7 gene detc abnor allele","description":"Atxn7 (ataxin 7) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65235","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from anterior chamber of eye or lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46604","name":"Anoscopy and dilation","description":"Anoscopy; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27326","name":"Neurectomy popliteal","description":"Neurectomy, popliteal (gastrocnemius)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92996","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"17111","name":"Destruction b9 lesions 15/>","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47531","name":"Injection for cholangiogram","description":"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44202","name":"Lap enterectomy","description":"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35697","name":"Reimplant artery each","description":"Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87510","name":"Gardner vag dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96521","name":"Refill/maint portable pump","description":"Refilling and maintenance of portable pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"R0070","name":"Transport portable x-ray","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, one patient seen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84830","name":"Ovulation tests","description":"Ovulation tests, by visual color comparison methods for human luteinizing hormone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85366","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); paracoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35256","name":"Repair blvsl vn grf lxtr","description":"Repair blood vessel with vein graft; lower extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4527.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11183.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2119.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92508","name":"Tx sp lang voice comm group","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39421.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21705","name":"Revision of neck muscle/rib","description":"Division of scalenus anticus; with resection of cervical rib","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29874","name":"Arthrs knee surg rmv loos/fb","description":"Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61584","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33517","name":"Cabg artery-vein single","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99485","name":"Suprv interfacilty transport","description":"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data inter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51596","name":"Remove bladder/create pouch","description":"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4485.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44363","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38531","name":"Open bx/exc inguinofem nodes","description":"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"17311","name":"Mohs 1 stage h/n/hf/g","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), h","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84030","name":"Assay of blood pku","description":"Phenylalanine (pku), blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21344","name":"Open tx compl front sinus fx","description":"Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29885","name":"Arthrs kne srg drlg ost diss","description":"Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0083","name":"Care man h v ext pt 45 m","description":"Moderate (45 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54692","name":"Laparoscopy orchiopexy","description":"Laparoscopy, surgical; orchiopexy for intra-abdominal testis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29866","name":"Autgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograft[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44133","name":"Enterectomy live donor","description":"Donor enterectomy (including cold preservation), open; partial, from living donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65285","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4185","name":"Pn soln nos 10 grams lipids","description":"Parenteral nutrition solution, not otherwise specified, 10 grams lipids","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"81422","name":"Fetal chrmoml microdeltj","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, digeorge syndrome, cri-du-chat syndrome), circulating cell-free fetal dna in maternal blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56630","name":"Vulvectomy radical partial","description":"Vulvectomy, radical, partial;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93613","name":"Intracardiac ephys 3d mapg","description":"Intracardiac electrophysiologic 3-dimensional mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86831","name":"Hla class ii phenotype qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); antibody identification by qualitative panel using complete hla phenotypes, hla class ii","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23921","name":"Disarticulation sho sec clsr","description":"Disarticulation of shoulder; secondary closure or scar revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84681","name":"Assay of c-peptide","description":"C-peptide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1459.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86155","name":"Chemotaxis assay","description":"Chemotaxis assay, specify method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36246","name":"Ins cath abd/l-ext art 2nd","description":"Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92100","name":"Serial tonometry","description":"Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment of acute elevation of intraocular pressure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30115","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), extensive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25560","name":"Cltx rdl&uln shft fx wo mnpj","description":"Closed treatment of radial and ulnar shaft fractures; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91315","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66150","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trephination with iridectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58545","name":"Laparoscopic myomectomy","description":"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1607.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56637","name":"Vlvctmy rad comp bi lymphad","description":"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3891","name":"Torsion mechanism wrist/elbo","description":"Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23130","name":"Acromp/acromionectomy prtl","description":"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47145","name":"Prep donor liver lobe split","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe spli","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63102","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6262","name":"Wound filler dry form / gram","description":"Wound filler, dry form, per gram, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6201","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23550","name":"Optx acromclv dislc aqt/chrn","description":"Open treatment of acromioclavicular dislocation, acute or chronic;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78593","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8505","name":"Artificial larynx, accessory","description":"Artificial larynx replacement battery / accessory, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4657.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61450","name":"Crnec stpl sctj cmprn/dcmprn","description":"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14000","name":"Tis trnfr trunk 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29881","name":"Arthrs kne srg mnisectmy m/l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45333","name":"Sigmoidoscopy & polypectomy","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94777","name":"Ped home apnea mntr rvw i&r","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21155","name":"Rcnstj mdfc lefort iii w/i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92617","name":"Fees w/laryngeal sense i&r","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93613","name":"Intracardiac ephys 3d mapg","description":"Intracardiac electrophysiologic 3-dimensional mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33427","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80150","name":"Assay of amikacin","description":"Amikacin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21422","name":"Optx palatal/max fracture","description":"Open treatment of palatal or maxillary fracture (lefort i type);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42844","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap (eg, tongue, buccal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559T","name":"Antmc mdl 3d print 1st cmpnt","description":"Anatomic model 3d-printed from image data set(s); first individually prepared and processed component of an anatomic structure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87206","name":"Smear fluorescent/acid stai","description":"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4180","name":"Parenteral sol carb > 50%","description":"Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77079","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57461","name":"Conz of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86593","name":"Syphilis test non-trep quant","description":"Syphilis test, non-treponemal antibody; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37760","name":"Lig prfratr vn radical 1 leg","description":"Ligation of perforator veins, subfascial, radical (linton type), including skin graft, when performed, open,1 leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21256","name":"Reconstruction of orbit","description":"Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64787","name":"Implant nerve end","description":"Implantation of nerve end into bone or muscle (list separately in addition to neuroma excision)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35281","name":"Rpr blvsl gr ot/th vn ntr-ab","description":"Repair blood vessel with graft other than vein; intra-abdominal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44158","name":"Colectomy w/neo-rectum pouch","description":"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (s or j), includes loop ileostomy, and rectal mucosectomy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35276","name":"Rpr blvs gr ot/t vn ntrth wo","description":"Repair blood vessel with graft other than vein; intrathoracic, without bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32856","name":"Prepare donor lung double","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0504","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15260","name":"Fth/gft fr n/e/e/l 20 sqcm/<","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25076","name":"Exc forearm tum deep < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61607","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62324","name":"Njx interlaminar crv/thrc","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thorac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"45346","name":"Sigmoidoscopy w/ablation","description":"Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1811.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5199.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27245","name":"Treat thigh fracture","description":"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52334","name":"Create passage to kidney","description":"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4541","name":"Large disposable underpad","description":"Incontinence product, disposable underpad, large, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11311","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69715","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2492.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42826","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; age 12 or over","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48155.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36217","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66170","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3671.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82085","name":"Assay of aldolase","description":"Aldolase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69610","name":"Tympanic membrane repair","description":"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28322","name":"Repair of metatarsals","description":"Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3003.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0247","name":"Trans bench w/wo comm open","description":"Transfer bench for tub or toilet with or without commode opening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41872","name":"Gingivoplasty each quadrant","description":"Gingivoplasty, each quadrant (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0999","name":"Add to spinal orthosis nos","description":"Addition to spinal orthosis, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27333","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial and lateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23140","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33946","name":"Ecmo/ecls initiation venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-venous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54336","name":"Revise penis/urethra","description":"1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64865","name":"Repair of facial nerve","description":"Suture of facial nerve; infratemporal, with or without grafting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46742","name":"Repair of imperforated anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62165","name":"Remove pituit tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90956","name":"Esrd srv 1 visit p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0246","name":"Transfer tub rail attachment","description":"Transfer tub rail attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33228","name":"Remv&replc pm gen dual lead","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; dual lead system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4459","name":"Transanal irrigation, manual","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21049","name":"Excis uppr jaw cyst w/repair","description":"Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95834","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27220","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32665","name":"Thoracoscop w/esoph musc exc","description":"Thoracoscopy, surgical; with esophagomyotomy (heller type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62162","name":"Remove colloid cyst w/scope","description":"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2092.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61735","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32420","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52310","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58146","name":"Myomectomy abdom complex","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15847","name":"Exc skin abd add-on","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69820","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49435","name":"Insert subq exten to ip cath","description":"Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83901","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"41530","name":"Tongue base vol reduction","description":"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33271","name":"Insj subq impltbl dfb elctrd","description":"Insertion of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2426.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96125","name":"Cognitive test by hc pro","description":"Standardized cognitive performance testing (eg, ross information processing assessment) per hour of a qualified health care professionals time, both face-to-face time administering tests to the patient and time interpreting these test results and preparing the report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82746","name":"Assay of folic acid serum","description":"Folic acid; serum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27562","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34844","name":"Endovasc visc aorta 4 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86185","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25525","name":"Optx rdl shft fx&cltx rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes percutaneous skeletal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62325","name":"Njx interlaminar crv/thrc","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thorac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8936.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5097.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64577","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24110","name":"Exc/curtg b1 cst/b9 tum hum","description":"Excision or curettage of bone cyst or benign tumor, humerus;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0202U","name":"Nfct ds 22 trgt sars-cov-2","description":"Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (dna or rna), 22 targets including severe acute respiratory syndrome coronavirus 2 (sars-cov-2), qualitative rt-pcr, nasopharyngeal swab, each pathogen reported as detected or not detected","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33969","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15829","name":"Rhytidectomy smas flap","description":"Rhytidectomy; superficial musculoaponeurotic system (smas) flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4730","name":"Fistula cannulation set, ea","description":"Fistula cannulation set for hemodialysis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3208","name":"Surgical boot each infant","description":"Surgical boot, each, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46760","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; muscle transplant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26725","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66020","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); air or liquid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35207","name":"Rpr bld vsl dir hand finger","description":"Repair blood vessel, direct; hand, finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63265","name":"Excise intraspinl lesion crv","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71060","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99471","name":"Ped critical care initial","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99192","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27253","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, without internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87279","name":"Parainfluenza ag if","description":"Infectious agent antigen detection by immunofluorescent technique; parainfluenza virus, each type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"67340","name":"Revise eye muscle add-on","description":"Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61596","name":"Transcochlear approach/skull","description":"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54650","name":"Orchiopexy (fowler-stephens)","description":"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler-stephens)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99451","name":"Ntrprof ph1/ntrnet/ehr 5/>","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a written report to the patients treating/requesting physician or other qualified health care professional, 5 mi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81166","name":"Brca1 gene full dup/del alys","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5266","name":"Battery for hearing device","description":"Battery for use in hearing device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83873","name":"Assay of csf protein","description":"Myelin basic protein, cerebrospinal fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96936","name":"Rcm i&r only ea addl lesion","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; interpretation and report only, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63272","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2054.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8353.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52647","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43180","name":"Esophagoscopy rigid trnso","description":"Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or cervical esophagus (eg, zenkers diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15135","name":"Drm agrft f/s/n/h/f/g/m 1st","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64605","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31032","name":"Explore sinus remove polyps","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) with removal of antrochoanal polyps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64708","name":"Revise arm/leg nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0337","name":"Hospice evaluation preelecti","description":"Hospice evaluation and counseling services, pre-election","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43771","name":"Lap revise gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2058.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92990","name":"Revision of pulmonary valve","description":"Percutaneous balloon valvuloplasty; pulmonary valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33220","name":"Repair lead pace-defib dual","description":"Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0480T","name":"Fxjl abl lsr ea addl 100sqcm","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33710","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0467T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26445","name":"Release hand/finger tendon","description":"Tenolysis, extensor tendon, hand or finger, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43118","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21933","name":"Exc back tum deep 5 cm/>","description":"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64614","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36481","name":"Insertion of catheter vein","description":"Percutaneous portal vein catheterization by any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33986","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53855","name":"Insert prost urethral stent","description":"Insertion of a temporary prostatic urethral stent, including urethral measurement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45300","name":"Proctosigmoidoscopy dx","description":"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27552","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24420","name":"Osteoplasty humerus","description":"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24620","name":"Cltx monteggia fx dislc elbw","description":"Closed treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4911","name":"Drain bag/bottle","description":"Drain bag/bottle, for dialysis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33237","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8244.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92012","name":"Intrm oph exam est patient","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60540","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21925","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; deep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45355","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96152","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"81177","name":"Atn1 gene detc abnor alleles","description":"Atn1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83925","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29893","name":"Endoscopic plantr fasciotomy","description":"Endoscopic plantar fasciotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53444","name":"Insert tandem cuff","description":"Insertion of tandem cuff (dual cuff)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2563.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82553","name":"Creatine mb fraction","description":"Creatine kinase (ck), (cpk); mb fraction only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0561T","name":"Antmc guide 3d print 1st gd","description":"Anatomic guide 3d-printed and designed from image data set(s); first anatomic guide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8936.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14301","name":"Tis trnfr any 30.1-60 sq cm","description":"Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20975","name":"Estim aid bone healg invasiv","description":"Electrical stimulation to aid bone healing; invasive (operative)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15774","name":"Gfrg autol fat lipo ea addl","description":"Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28050","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; intertarsal or tarsometatarsal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80166","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44121","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98970","name":"Nqhp ol dig assmt&mgmt 5-10","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99363","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36590","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28114","name":"Removal of metatarsal heads","description":"Ostectomy, complete excision; all metatarsal heads, with partial proximal phalangectomy, excluding first metatarsal (eg, clayton type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2286.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82657","name":"Enzyme cell activity","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; nonradioactive substrate, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80182","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37700","name":"Ligation&div long saph vein","description":"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57135","name":"Excision vaginal cyst/tumor","description":"Excision of vaginal cyst or tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33920","name":"Repair pulmonary atresia","description":"Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93720","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0082","name":"Care man h v ext pt 30 m","description":"Limited (30 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6455.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99447","name":"Ntrprof ph1/ntrnet/ehr 11-20","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58950","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97035","name":"App mdlty 1+ultrasound ea 15","description":"Application of a modality to 1 or more areas; ultrasound, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26670","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67500","name":"Inject/treat eye socket","description":"Retrobulbar injection; medication (separate procedure, does not include supply of medication)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61333","name":"Expl orbit w/removal lesion","description":"Exploration of orbit (transcranial approach), with removal of lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0151T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61800","name":"Apply srs headframe add-on","description":"Application of stereotactic headframe for stereotactic radiosurgery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23035","name":"Incision bone cortex sho","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96105","name":"Assessment of aphasia","description":"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by boston diagnostic aphasia examination) with interpretation and report, per hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44213","name":"Lap mobil splenic fl add-on","description":"Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44127","name":"Enterectomy w/taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; with tapering","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66988","name":"Xcapsl ctrc rmvl w/ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic cyclophotocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566T","name":"Autol cell implt adps njx","description":"Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; injection of cellular implant into knee joint including ultrasound guidance, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9483","name":"Remote e/m new pt 30mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real tim","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86255","name":"Fluorescent antibody screen","description":"Fluorescent noninfectious agent antibody; screen, each antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31649","name":"Bronchial valve remov addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38510","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28005","name":"Treat foot bone lesion","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26442","name":"Release palm & finger tendon","description":"Tenolysis, flexor tendon; palm and finger, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10160","name":"Pnxr aspir absc hmtma bulla","description":"Puncture aspiration of abscess, hematoma, bulla, or cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95120","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45389","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63011","name":"Remove spine lamina 1/2 scrl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15650","name":"Transfer skin pedicle flap","description":"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, walking tube), any location","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33534","name":"Cabg arterial two","description":"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21422","name":"Optx palatal/max fracture","description":"Open treatment of palatal or maxillary fracture (lefort i type);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38525","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep axillary node(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0013A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27096","name":"Inject sacroiliac joint","description":"Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or ct) including arthrography when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28296","name":"Cor hlx vlgs dstl mtar osteo","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61886","name":"Implant neurostim arrays","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50600","name":"Exploration of ureter","description":"Ureterotomy with exploration or drainage (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96368","name":"Ther/diag concurrent inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69020","name":"Drg xtrnl aud canal abscess","description":"Drainage external auditory canal, abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86631","name":"Chlamydia antibody","description":"Antibody; chlamydia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23200","name":"Radical rescj tumor clavicle","description":"Radical resection of tumor; clavicle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33261","name":"Ablate heart dysrhythm focus","description":"Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3652","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3290.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86329","name":"Immunodiffusion nes","description":"Immunodiffusion; not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43774","name":"Lap rmvl gastr adj all parts","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36471","name":"Njx sclrsnt mlt incmptnt vn","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33440","name":"Rplcmt a-valve tlcj autol pv","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (ross-konno procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4034","name":"Enter feed supkit syr by day","description":"Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64510","name":"N block stellate ganglion","description":"Injection, anesthetic agent; stellate ganglion (cervical sympathetic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26260","name":"Resect prox finger tumor","description":"Radical resection of tumor, proximal or middle phalanx of finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97762","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8697.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2794.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93656","name":"Compre ep eval abltj atr fib","description":"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, and intracardiac catheter ablation of atrial fibrillation by ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25800","name":"Arthrd wrist complete wo grf","description":"Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or intercarpal and/or carpometacarpal joints)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24685","name":"Optx ulnar fx prox end w/fix","description":"Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0271","name":"Group mnt 2 or more 30 mins","description":"Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85536","name":"Iron stain peripheral blood","description":"Iron stain, peripheral blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24116","name":"Exc/crtg b1 cst/tum hum algr","description":"Excision or curettage of bone cyst or benign tumor, humerus; with allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4087","name":"Gastro/jejuno tube, std","description":"Gastrostomy/jejunostomy tube, standard, any material, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54135","name":"Remove penis & nodes","description":"Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82607","name":"Vitamin b-12","description":"Cyanocobalamin (vitamin b-12);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86606","name":"Aspergillus antibody","description":"Antibody; aspergillus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12032","name":"Intmd rpr s/a/t/ext 2.6-7.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58572","name":"Tlh uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25375","name":"Revise radius & ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius and ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36222","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65150","name":"Revise ocular implant","description":"Reinsertion of ocular implant; with or without conjunctival graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21256","name":"Reconstruction of orbit","description":"Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83840","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45915","name":"Remove rectal obstruction","description":"Removal of fecal impaction or foreign body (separate procedure) under anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3214","name":"Benesch boot pair junior","description":"Benesch boot, pair, junior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"17273","name":"Dstr mal les s/n/h/f/g 2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5103.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35539","name":"Art byp grft aortofemoral","description":"Bypass graft, with vein; aortofemoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87525","name":"Hepatitis g dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87275","name":"Influenza b ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza b virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4707","name":"Bicarbonate conc pow per pac","description":"Bicarbonate concentrate, powder, for hemodialysis, per packet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43882","name":"Rev/rmvl gstr nstim eltrd","description":"Revision or removal of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11901","name":"Inject skin lesions >7","description":"Injection, intralesional; more than 7 lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44146","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22527","name":"Idet 1 or more levels","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1508.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46210","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81337","name":"Smn1 gen nown famil seq vrnt","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46220","name":"Excise anal ext tag/papilla","description":"Excision of single external papilla or tag, anus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57283","name":"Colpopexy intraperitoneal","description":"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83662","name":"Foam stability fetal lung","description":"Fetal lung maturity assessment; foam stability test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86765","name":"Rubeola antibody","description":"Antibody; rubeola","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33533","name":"Cabg arterial single","description":"Coronary artery bypass, using arterial graft(s); single arterial graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36870","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77032","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61605","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64891","name":"Nrv grf 1strnd hnd/foot >4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"B4224","name":"Parenteral administration ki","description":"Parenteral nutrition administration kit, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43217","name":"Esophagoscopy snare les remv","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81172","name":"Aff2 gen alys charac alleles","description":"Aff2 (alf transcription elongation factor 2 [fmr2]) (eg, fragile x intellectual disability 2 [fraxe]) gene analysis; characterization of alleles (eg, expanded size and methylation status)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29700","name":"Rmvl/bivlv gauntlet boot/cst","description":"Removal or bivalving; gauntlet, boot or body cast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66165","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28297","name":"Cor hlx vlgs jt arthrd","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40650","name":"Rpr lip fth vermilion only","description":"Repair lip, full thickness; vermilion only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44700","name":"Suspend bowel w/prosthesis","description":"Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder or omentum)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4522","name":"Adult size brief/diaper med","description":"Adult sized disposable incontinence product, brief/diaper, medium, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87581","name":"M.pneumon dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36013","name":"Place catheter in artery","description":"Introduction of catheter, right heart or main pulmonary artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0454","name":"Md document visit by npp","description":"Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47425","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31288","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81336","name":"Smn1 gene full gene sequence","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; full gene sequence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87391","name":"Hiv-2 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3535.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"Prev visit new age 12-17","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6142.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37221","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66852","name":"Removal of lens material","description":"Removal of lens material; pars plana approach, with or without vitrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4471.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82638","name":"Assay of dibucaine number","description":"Dibucaine number","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83015","name":"Heavy metal qual any number","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP06","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50070","name":"Nl comp cgen kdn abnormality","description":"Nephrolithotomy; complicated by congenital kidney abnormality","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94781","name":"Cars/bd tst inft-12mo +30min","description":"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; each additional full 30 minutes (list separately in addition to code","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0245","name":"Tub stool or bench","description":"Tub stool or bench","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37233","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44155","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with ileostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1682.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2086","name":"Off base opioid tx 70min","description":"Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35494","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96933","name":"Rcm i&r only 1st lesion","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; interpretation and report only, first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11441","name":"Exc face-mm b9+marg 0.6-1 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27758","name":"Treatment of tibia fracture","description":"Open treatment of tibial shaft fracture (with or without fibular fracture), with plate/screws, with or without cerclage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8379.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"61609","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99316","name":"Nf dschrg mgmt 30 min+","description":"Nursing facility discharge management; more than 30 minutes total time on the date of the encounter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73542","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24538","name":"Prq skel fix sprcndlr hum fx","description":"Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562T","name":"Antmc guide 3d print ea addl","description":"Anatomic guide 3d-printed and designed from image data set(s); each additional anatomic guide (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29875","name":"Arthrs knee surg synvct lmtd","description":"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92995","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83894","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33310","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21209","name":"Reduction of facial bones","description":"Osteoplasty, facial bones; reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61618","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33602","name":"Closure of valve","description":"Closure of semilunar valve (aortic or pulmonary) by suture or patch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2440.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24600","name":"Tx clsd elbow dislc w/o anes","description":"Treatment of closed elbow dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27654","name":"Repair of achilles tendon","description":"Repair, secondary, achilles tendon, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22015","name":"I&d abscess p-spine l/s/ls","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77373","name":"Strtctc bdy rad ther tx dlvr","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20704","name":"Mnl prep&insj i-artic rx dev","description":"Manual preparation and insertion of drug-delivery device(s), intra-articular (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35013","name":"Repair artery rupture arm","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20937","name":"Sp bone agrft morsel add-on","description":"Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57022","name":"I&d vaginal hematoma ob/pp","description":"Incision and drainage of vaginal hematoma; obstetrical/postpartum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1872.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87809","name":"Adenovirus assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21261","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61305","name":"Crnec/crnot expl infratntorl","description":"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92569","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92312","name":"Contact lens fitg aphakia ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87640","name":"Staph a dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); staphylococcus aureus, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27347","name":"Remove knee cyst","description":"Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49611","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); second stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46762","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65880","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99116","name":"Anes comp tot bdy hypthrm","description":"Anesthesia complicated by utilization of total body hypothermia (list separately in addition to code for primary anesthesia procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95720","name":"Eeg phy/qhp ea incr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of eeg recording, interpretation and report after each 24-hour period; w","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21060","name":"Remove jaw joint cartilage","description":"Meniscectomy, partial or complete, temporomandibular joint (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26060","name":"Incision of finger tendon","description":"Tenotomy, percutaneous, single, each digit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25259","name":"Manipulate wrist w/anesthes","description":"Manipulation, wrist, under anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90809","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15277","name":"Skn sub grft f/n/hf/g child","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27259","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47802","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33230","name":"Insrt pulse gen w/dual leads","description":"Insertion of implantable defibrillator pulse generator only; with existing dual leads","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25295","name":"Release wrist/forearm tendon","description":"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23670","name":"Optx sho dislc fx","description":"Open treatment of shoulder dislocation, with fracture of greater humeral tuberosity, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28140","name":"Removal of metatarsal","description":"Metatarsectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11975","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9555","name":"Rb82 rubidium","description":"Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58291","name":"Vag hyst incl t/o complex","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90913","name":"Bfb training ea addl 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; each additional 15 minutes of one-on-one physician or other qualified health care professional contact with the patient (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0269","name":"Occlusive device in vein art","description":"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"C1751","name":"Cath, inf, per/cent/midline","description":"Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63287","name":"Bx/exc idrl imed lesn thrlmb","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22868","name":"Insj stablj dev w/dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49083","name":"Abd paracentesis w/imaging","description":"Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19283","name":"Perq dev breast 1st strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50572","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84252","name":"Assay of vitamin b-2","description":"Riboflavin (vitamin b-2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44212","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34708","name":"Evasc rpr ilio-iliac rpt","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1620.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57283","name":"Colpopexy intraperitoneal","description":"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88140","name":"Sex chromatin identification","description":"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87380","name":"Hepatitis delta agent ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis, delta agent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90467","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15650","name":"Transfer skin pedicle flap","description":"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, walking tube), any location","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36005","name":"Injection ext venography","description":"Injection procedure for extremity venography (including introduction of needle or intracatheter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23485","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95714","name":"Veeg ea 12-26 hr unmntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; unmonitored","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2352.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87899","name":"Agent nos assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47371","name":"Laparo ablate liver cryosurg","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43610","name":"Excision of stomach lesion","description":"Excision, local; ulcer or benign tumor of stomach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75685","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21047","name":"Excise lwr jaw cyst w/repair","description":"Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60280","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3230","name":"Custom shoes depth inlay","description":"Orthopedic footwear, custom shoe, depth inlay, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33774","name":"Rpr tga atrial baffle px","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2667.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93236","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95992","name":"Canalith repositioning proc","description":"Canalith repositioning procedure(s) (eg, epley maneuver, semont maneuver), per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81306","name":"Nudt15 gene common variants","description":"Nudt15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27724","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"66184","name":"Revision of aqueous shunt","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49606","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52630","name":"Remove prostate regrowth","description":"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57415","name":"Remove vaginal foreign body","description":"Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0239","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23071","name":"Exc shoulder les sc 3 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38232","name":"Bone marrow harvest autolog","description":"Bone marrow harvesting for transplantation; autologous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25073","name":"Exc forearm tum deep 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88273","name":"Cytogenetics 10-30","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45308","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36245","name":"Ins cath abd/l-ext art 1st","description":"Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10007","name":"Fna bx w/fluor gdn 1st les","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23616","name":"Optx prx hmrl fx fix rpr rpl","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00452","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33677","name":"Cl mult vsd w/rem pul band","description":"Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81190","name":"Cstb gene known famil vrnt","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; known familial variant(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2305.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77336","name":"Radiation physics consult","description":"Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96131","name":"Psycl tst eval phys/qhp ea","description":"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27240","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3254","name":"Orth foot non-stndard size/w","description":"Non-standard size or width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4500","name":"Below knee surgical stocking","description":"Surgical stockings below knee length, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55876","name":"Place rt device/marker pros","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95075","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15937","name":"Exc sac pr ulc prep mus ostc","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69605","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12006","name":"Rpr s/n/a/gen/trk20.1-30.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36569","name":"Insj picc 5 yr+ w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; age 5 years or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9512","name":"Tc99m pertechnetate","description":"Technetium tc-99m pertechnetate, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27722","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with sliding graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25530","name":"Cltx ulnar shft fx w/o mnpj","description":"Closed treatment of ulnar shaft fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92547","name":"Supplemental electrical test","description":"Use of vertical electrodes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27520","name":"Treat kneecap fracture","description":"Closed treatment of patellar fracture, without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90468","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11106","name":"Incal bx skn single les","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83661","name":"L/s ratio fetal lung","description":"Fetal lung maturity assessment; lecithin sphingomyelin (l/s) ratio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87562","name":"M.avium-intra dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27165","name":"Incision/fixation of femur","description":"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"22808","name":"Arthrd ant dfrm 2-3 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15950","name":"Exc trchntr pr ulc prim sutr","description":"Excision, trochanteric pressure ulcer, with primary suture;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61001","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19316","name":"Mastopexy","description":"Mastopexy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43244","name":"Egd varices ligation","description":"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67040","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0318","name":"Prolong home eval add 15m","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77371","name":"Srs multisource","description":"Radiation treatment delivery, stereotactic radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source cobalt 60 based","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35650","name":"Bpg axillary-axillary","description":"Bypass graft, with other than vein; axillary-axillary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4137.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45382","name":"Colonoscopy w/control bleed","description":"Colonoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85291","name":"Clot factor xiii fibrin scrn","description":"Clotting; factor xiii (fibrin stabilizing), screen solubility","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86822","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93540","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92358","name":"Aphakia prosth service temp","description":"Prosthesis service for aphakia, temporary (disposable or loan, including materials)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"99379","name":"Nursing fac care supervision","description":"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, comm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27246","name":"Treat thigh fracture","description":"Closed treatment of greater trochanteric fracture, without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99145","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95940","name":"Ionm in operatng room 15 min","description":"Continuous intraoperative neurophysiology monitoring in the operating room, one on one monitoring requiring personal attendance, each 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4213","name":"20+ cc syringe only","description":"Syringe, sterile, 20 cc or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65765","name":"Keratophakia","description":"Keratophakia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25040","name":"Arthrt rdcrpl/midcarpl jt","description":"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4216","name":"Parenteral nutrition additiv","description":"Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24101","name":"Arthrt elbw jt expl bx rmvl","description":"Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1904.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3701","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"81539","name":"Oncology prostate prob score","description":"Oncology (high-grade prostate cancer), biochemical assay of four proteins (total psa, free psa, intact psa, and human kallikrein-2 [hk2]), utilizing plasma or serum, prognostic algorithm reported as a probability score","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5469.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38204","name":"Bl donor search management","description":"Management of recipient hematopoietic progenitor cell donor search and cell acquisition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53852","name":"Prostatic rf thermotx","description":"Transurethral destruction of prostate tissue; by radiofrequency thermotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43830","name":"Gstrst open wo constj tube","description":"Gastrostomy, open; without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66770","name":"Removal of inner eye lesion","description":"Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83897","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86940","name":"Hemolysins/agglutinins auto","description":"Hemolysins and agglutinins; auto, screen, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15111","name":"Epidrm agrft t/a/l ea addl","description":"Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43280","name":"Laparoscopy fundoplasty","description":"Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26116","name":"Exc hand tum deep < 1.5 cm","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28300","name":"Incision of heel bone","description":"Osteotomy; calcaneus (eg, dwyer or chambers type procedure), with or without internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570T","name":"Ttvr perq ea addl prosth","description":"Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4097","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67880","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66820","name":"Incision secondary cataract","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (ziegler or wheeler knife)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15044.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64885","name":"Nerve graft head/neck <4 cm","description":"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50320","name":"Remove kidney living donor","description":"Donor nephrectomy (including cold preservation); open, from living donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63043","name":"Laminotomy addl cervical","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional cervical interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24076","name":"Ex arm/elbow tum deep < 5 cm","description":"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5693.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96931","name":"Rcm img acquisj&i&r 1st les","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, first lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33971","name":"Aortic circulation assist","description":"Removal of intra-aortic balloon assist device including repair of femoral artery, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86235","name":"Nuclear antigen antibody","description":"Extractable nuclear antigen, antibody to, any method (eg, nrnp, ss-a, ss-b, sm, rnp, sc170, j01), each antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3287.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34101","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4706","name":"Bicarbonate conc sol per gal","description":"Bicarbonate concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96133","name":"Nrpsyc tst eval phys/qhp ea","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the pati","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9485","name":"Remote e/m new pt 60mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60505","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81121","name":"Idh2 common variants","description":"Idh2 (isocitrate dehydrogenase 2 [nadp+], mitochondrial) (eg, glioma), common variants (eg, r140w, r172m)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26358","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31643","name":"Diag bronchoscope/catheter","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34834","name":"Opn brach art expos","description":"Open brachial artery exposure for delivery of endovascular prosthesis, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47539","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3899.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21146","name":"Rcnstj mdfc lefort i 2 w/grf","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3132.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64736","name":"Incision of chin nerve","description":"Transection or avulsion of; mental nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98975","name":"Rtm 1st set-up&pt educaj eqp","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); initial set-up and patient education on use of equipment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85046","name":"Reticyte/hgb concentrate","description":"Blood count; reticulocytes, automated, including 1 or more cellular parameters (eg, reticulocyte hemoglobin content [chr], immature reticulocyte fraction [irf], reticulocyte volume [mrv], rna content), direct measurement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87798","name":"Detect agent nos dna amp","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; amplified probe technique, each organism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"61542","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11644","name":"Exc f/e/e/n/l mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47350","name":"Repair liver wound","description":"Management of liver hemorrhage; simple suture of liver wound or injury","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2012","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0497T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2999","name":"Lower extremity orthosis nos","description":"Lower extremity orthoses, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43645","name":"Lap gastr bypass incl smll i","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93241","name":"Xtrnl ecg rec>48hr<7d","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10180","name":"I&d complex po wound infctj","description":"Incision and drainage, complex, postoperative wound infection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24359","name":"Repair elbow deb/attch open","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35471","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32488","name":"Completion pneumonectomy","description":"Removal of lung, other than pneumonectomy; with all remaining lung following previous removal of a portion of lung (completion pneumonectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32820","name":"Reconstruct injured chest","description":"Major reconstruction, chest wall (posttraumatic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4860","name":"Disposable catheter tips","description":"Disposable catheter tips for peritoneal dialysis, per 10","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15574","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","description":"Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2063","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0191T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51030","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15833","name":"Exc excessive skin leg","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28238","name":"Revision of foot tendon","description":"Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, kidner type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25272","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27625","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43265","name":"Ercp lithotripsy calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19105","name":"Cryosurg ablate fa each","description":"Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28173","name":"Resect metatarsal tumor","description":"Radical resection of tumor; metatarsal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58260","name":"Vaginal hysterectomy","description":"Vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80412","name":"Crh stimulation panel","description":"Corticotropic releasing hormone (crh) stimulation panel this panel must include the following: cortisol (82533 x 6) adrenocorticotropic hormone (acth) (82024 x 6)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92607","name":"Ex for speech device rx 1hr","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75790","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88273","name":"Cytogenetics 10-30","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44111","name":"Excision of bowel lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32501","name":"Repair bronchus add-on","description":"Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64472","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55842","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64766","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26554","name":"Double transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25246","name":"Injection for wrist x-ray","description":"Injection procedure for wrist arthrography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28234","name":"Incision of foot tendon","description":"Tenotomy, open, extensor, foot or toe, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35122","name":"Repair artery rupture belly","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80305","name":"Drug test prsmv dir opt obs","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37214","name":"Cessj therapy cath removal","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44386","name":"Endoscopy bowel pouch/biop","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"49061","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0512","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3265","name":"Plastazote sandal each","description":"Plastazote sandal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83582","name":"Assay of ketogenic steroids","description":"Ketogenic steroids, fractionation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34825","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67107","name":"Repair detached retina","description":"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23525","name":"Cltx strnclav dislc w/mnpj","description":"Closed treatment of sternoclavicular dislocation; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32503","name":"Resect apical lung tumor","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97010","name":"Hot or cold packs therapy","description":"Application of a modality to 1 or more areas; hot or cold packs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61795","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3215","name":"Orthopedic ftwear ladies oxf","description":"Orthopedic footwear, ladies shoe, oxford, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0340","name":"Robt lin-radsurg fractx 2-5","description":"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6024","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2118.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01953","name":"Anes 2&3 burn ea add 9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (list separately in addition to code for primary procedur","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36568","name":"Insj picc <5 yr w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98962","name":"Edu&trn pt slf-mgmt nqhp 5-8","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4164","name":"Parenteral 50% dextrose solu","description":"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33778","name":"Rpr tga aortic pulm art rcns","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22114","name":"Remove part lumbar vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26742","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84588","name":"Assay of vasopressin","description":"Vasopressin (antidiuretic hormone, adh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36513","name":"Apheresis platelets","description":"Therapeutic apheresis; for platelets","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82163","name":"Assay of angiotensin ii","description":"Angiotensin ii","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33227","name":"Remove&replace pm gen singl","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; single lead system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24515","name":"Optx humrl shft fx plate/scr","description":"Open treatment of humeral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45112","name":"Removal of rectum","description":"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27457","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87496","name":"Cytomeg dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95004","name":"Perq tests w/alrgnc xtrcs","description":"Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32657","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11719","name":"Trim nail(s) any number","description":"Trimming of nondystrophic nails, any number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37186","name":"Sec art thrombectomy add-on","description":"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63051","name":"C-laminoplasty w/graft/plate","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64635","name":"Destroy lumb/sac facet jnt","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, single facet joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64897","name":"Nrv grf mltst arm/leg <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10368.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83491","name":"Asy hydroxycorticosteroids17","description":"Hydroxycorticosteroids, 17- (17-ohcs)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43314","name":"Tracheo-esophagoplasty cong","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84377","name":"Sugars multiple qual","description":"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92070","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87516","name":"Hepatitis b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83908","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97110","name":"Therapeutic exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64451","name":"Njx aa&/strd nrv nrvtg si jt","description":"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31525","name":"Dx laryngoscopy excl nb","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3917.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62284","name":"Injection for myelogram","description":"Injection procedure for myelography and/or computed tomography, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86870","name":"Rbc antibody identification","description":"Antibody identification, rbc antibodies, each panel for each serum technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67808","name":"Remove eyelid lesion(s)","description":"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4206","name":"1 cc sterile syringe&needle","description":"Syringe with needle, sterile, 1 cc or less, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21151","name":"Rcnstj mdfc lefrtii w/b1 grf","description":"Reconstruction midface, lefort ii; any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27517","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60270","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3253.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27540","name":"Treat knee fracture","description":"Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43401","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41019","name":"Place needles h&n for rt","description":"Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17107","name":"Dstr cut vsc prlf les10-50sq","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6201","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7266","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99488","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27409","name":"Repair of knee ligaments","description":"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95024","name":"Iq tests w/allergenic xtrcs","description":"Intracutaneous (intradermal) tests with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93651","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54435","name":"Revision of penis","description":"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, winter procedure, rongeur, or punch) for priapism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87280","name":"Respiratory syncytial ag if","description":"Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33213","name":"Insert pulse gen dual leads","description":"Insertion of pacemaker pulse generator only; with existing dual leads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G9187","name":"Bpci home visit","description":"Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/managemen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21139","name":"Rdctj forehead cntrg&setback","description":"Reduction forehead; contouring and setback of anterior frontal sinus wall","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25685","name":"Optx trns-scphprlnr fx dislc","description":"Open treatment of trans-scaphoperilunar type of fracture dislocation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3206","name":"Hightop w/ supp/pronator chi","description":"Orthopedic shoe, hightop with supinator or pronator, child","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75665","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8329.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33995","name":"Insj perq vad r hrt venous","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; right heart, venous access only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27485","name":"Surgery to stop leg growth","description":"Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0295T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29355","name":"Appl long leg cast walker","description":"Application of long leg cast (thigh to toes); walker or ambulatory type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36002","name":"Pseudoaneurysm injection trt","description":"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43279","name":"Lap myotomy heller","description":"Laparoscopy, surgical, esophagomyotomy (heller type), with fundoplasty, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67810","name":"Incal bx eyelid skn lid mrgn","description":"Incisional biopsy of eyelid skin including lid margin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63276","name":"Bx/exc xdrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27724","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1067.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23630","name":"Optx gr hmrl tbrs fx int fix","description":"Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26055","name":"Incise finger tendon sheath","description":"Tendon sheath incision (eg, for trigger finger)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61440","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95973","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20661","name":"Application halo cranial","description":"Application of halo, including removal; cranial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36583","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28200","name":"Repair of foot tendon","description":"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17003","name":"Destruct premalg les 2-14","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (list separately in addition to code for first lesion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22532","name":"Arthrd lat xtrcvtry tq thrc","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86353","name":"Lymphocyte transformation","description":"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82387","name":"Assay of cathepsin-d","description":"Cathepsin-d","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45382","name":"Colonoscopy w/control bleed","description":"Colonoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58958","name":"Resc recr ovr tbl pp utr mal","description":"Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed, with pelvic lymphadenectomy and limited para-aortic lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50650","name":"Removal of ureter","description":"Ureterectomy, with bladder cuff (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84490","name":"Assay of feces for trypsin","description":"Trypsin; feces, quantitative, 24-hour collection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15934","name":"Exc sacral pr ulc skn flap","description":"Excision, sacral pressure ulcer, with skin flap closure;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33231","name":"Insrt pulse gen w/mult leads","description":"Insertion of implantable defibrillator pulse generator only; with existing multiple leads","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2332.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31540","name":"Laryngoscopy w/exc of tumor","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3213.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11444","name":"Exc face-mm b9+marg 3.1-4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95075","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19283","name":"Perq dev breast 1st strtctc","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37221","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64487","name":"Tap block uni by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by continuous infusion(s) (includes imaging guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75662","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41009","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35495","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"81163","name":"Brca1&2 gene full seq alys","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44383","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58550","name":"Laparo-asst vag hysterectomy","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61651","name":"Evasc prlng admn rx agnt add","description":"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21260","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19285","name":"Perq dev breast 1st us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32480","name":"Partial removal of lung","description":"Removal of lung, other than pneumonectomy; single lobe (lobectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0077","name":"Care manag h vst new pt 30 m","description":"Limited (30 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54520","name":"Removal of testis","description":"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92943","name":"Prq trluml revsc ch occ ant","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; antegrade","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2066","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27228","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes t-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4397","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29851","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62267","name":"Interdiscal perq aspir dx","description":"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21030","name":"Excise max/zygoma b9 tumor","description":"Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43210","name":"Egd esophagogastrc fndoplsty","description":"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15152","name":"Tis cltr skn agrft t/a/l ea","description":"Tissue cultured skin autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86485","name":"Skin test candida","description":"Skin test; candida","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86821","name":"Lymphocyte culture mixed","description":"Hla typing; lymphocyte culture, mixed (mlc)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44208","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43234","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31237","name":"Nsl/sins ndsc surg bx polypc","description":"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52442","name":"Cysto ins trnsprstc implt ea","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13102","name":"Cmplx rpr trunk addl 5cm/<","description":"Repair, complex, trunk; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11471","name":"Exc skn h/p/p/u complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83861","name":"Microfluid analy tears","description":"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22212","name":"Incis 1 vertebral seg thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20939","name":"Bone marrow aspir bone grfg","description":"Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35311","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32553","name":"Ins mark thor for rt perq","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31820","name":"Closure of windpipe lesion","description":"Surgical closure tracheostomy or fistula; without plastic repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2002","name":"Post-d/c h vst new pt 30 m","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23030","name":"I&d shoulder deep absc/hmtma","description":"Incision and drainage, shoulder area; deep abscess or hematoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53400","name":"Revise urethra stage 1","description":"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, johannsen type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82376","name":"Assay carboxyhb qual","description":"Carboxyhemoglobin; qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31290","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36640","name":"Insertion catheter artery","description":"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96570","name":"Photodynmc tx 30 min add-on","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); first 30 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35682","name":"Composite byp grft 2 veins","description":"Bypass graft; autogenous composite, 2 segments of veins from 2 locations (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81513","name":"Nfct ds bv rna vag flu alg","description":"Infectious disease, bacterial vaginosis, quantitative real-time amplification of rna markers for atopobium vaginae, gardnerella vaginalis, and lactobacillus species, utilizing vaginal-fluid specimens, algorithm reported as a positive or negative result for bacterial vaginosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23220","name":"Radical rescj tumor prox hum","description":"Radical resection of tumor, proximal humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87529","name":"Hsv dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45500","name":"Repair of rectum","description":"Proctoplasty; for stenosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6009","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33440","name":"Rplcmt a-valve tlcj autol pv","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve (ross-konno procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86834","name":"Hla class i semiquant panel","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); semi-quantitative panel (eg, titer), hla class i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61850","name":"Implant neuroelectrodes","description":"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8227.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93722","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99406","name":"Behav chng smoking 3-10 min","description":"Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13151","name":"Cmplx rpr e/n/e/l 1.1-2.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61531","name":"Implant brain electrodes","description":"Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35634","name":"Bpg iliorenal","description":"Bypass graft, with other than vein; iliorenal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1564.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0237","name":"Therapeutic procd strg endur","description":"Therapeutic procedures to increase strength or endurance of respiratory muscles, face to face, one on one, each 15 minutes (includes monitoring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0448T","name":"Remvl insj impltbl gluc sens","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27429","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11307","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3615.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44020","name":"Explore small intestine","description":"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47712","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1768","name":"Graft, vascular","description":"Graft, vascular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22843","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24342","name":"Repair of ruptured tendon","description":"Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39561","name":"Resect diaphragm complex","description":"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58110","name":"Bx done w/colposcopy add-on","description":"Endometrial sampling (biopsy) performed in conjunction with colposcopy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21558","name":"Resect neck tumor 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63003","name":"Remove spine lamina 1/2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22870","name":"Insj stablj dev w/o dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52332","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66600","name":"Remove iris and lesion","description":"Iridectomy, with corneoscleral or corneal section; for removal of lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47765","name":"Fuse liver ducts & bowel","description":"Anastomosis, of intrahepatic ducts and gastrointestinal tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4104","name":"Additive for enteral formula","description":"Additive for enteral formula (e.g., fiber)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94350","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29566.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28055","name":"Neurectomy foot","description":"Neurectomy, intrinsic musculature of foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"40804","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9678","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32405","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5100.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46045","name":"I&d absc tranal under anes","description":"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35884","name":"Revj fem anast autog vn grf","description":"Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; with autogenous vein patch graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0306","name":"Cbc/diffwbc w/o platelet","description":"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81439","name":"Hrdtry cardmypy gene panel","description":"Hereditary cardiomyopathy (eg, hypertrophic cardiomyopathy, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), genomic sequence analysis panel, must include sequencing of at least 5 cardiomyopathy-related genes (eg, dsg2, mybpc3, myh7, pkp2, ttn)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85245","name":"Clot factor viii vw ristoctn","description":"Clotting; factor viii, vw factor, ristocetin cofactor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0001","name":"2019-ncov diagnostic p","description":"Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358T","name":"Bia whole body","description":"Bioelectrical impedance analysis whole body composition assessment, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6079.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36557","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83701","name":"Lipoprotein bld hr fraction","description":"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1607.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27067","name":"Remove/graft hip bone lesion","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; with autograft requiring separate incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0106T","name":"Touch quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using touch pressure stimuli to assess large diameter sensation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36440","name":"Bld push tfuj 2 yr/<","description":"Push transfusion, blood, 2 years or younger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42160","name":"Treatment mouth roof lesion","description":"Destruction of lesion, palate or uvula (thermal, cryo or chemical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92354","name":"Fitg spect low vis 1system","description":"Fitting of spectacle mounted low vision aid; single element system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0186","name":"Dstry eye lesn,fdr vssl tech","description":"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2554.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49651","name":"Lap ing hernia repair recur","description":"Laparoscopy, surgical; repair recurrent inguinal hernia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"B5200","name":"Parenteral sol hepatic fream","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, stress-branch chain amino acids-freamine-hbc-premix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92130","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50957","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22315","name":"Closed tx vert fx w/manj","description":"Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"41828","name":"Excision of gum lesion","description":"Excision of hyperplastic alveolar mucosa, each quadrant (specify)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78584","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10140","name":"I&d hmtma seroma/fluid collj","description":"Incision and drainage of hematoma, seroma or fluid collection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86904","name":"Blood typing patient serum","description":"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"12006","name":"Rpr s/n/a/gen/trk20.1-30.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11952","name":"Subq njx fil matrl 5.1-10cc","description":"Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"Home/res vst est low mdm 30","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84375","name":"Chromatogram assay sugars","description":"Sugars, chromatographic, tlc or paper chromatography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19316","name":"Mastopexy","description":"Mastopexy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34800","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39531","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2011","name":"Alcohol/sub misuse assess","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention, 5-14 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5020","name":"Conformity evaluation","description":"Conformity evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99420","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42870","name":"Excision of lingual tonsil","description":"Excision or destruction lingual tonsil, any method (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35142","name":"Repair artery rupture thigh","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3255","name":"Orth foot non-standard size/","description":"Non-standard size or length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37735","name":"Lig&div&compl strpg saph vn","description":"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99367","name":"Team conf w/o pat by phys","description":"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21435","name":"Optx crnfc sep comp int&/xtr","description":"Open treatment of craniofacial separation (lefort iii type); complicated, utilizing internal and/or external fixation techniques (eg, head cap, halo device, and/or intermaxillary fixation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50323","name":"Prep cadaver renal allograft","description":"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3350.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20982","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64476","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45385","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67221","name":"Ocular photodynamic ther","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5646.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83892","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29871","name":"Arthrs knee surg for infctj","description":"Arthroscopy, knee, surgical; for infection, lavage and drainage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50947","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25575","name":"Optx rdl&uln shft fx rds&uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius and ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57520","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4606.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27248","name":"Treat thigh fracture","description":"Open treatment of greater trochanteric fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4770","name":"Blood collection tube/vacuum","description":"Blood collection tube, vacuum, for dialysis, per 50","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63621","name":"Srs spinal lesion addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0511","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33516","name":"Cabg vein six or more","description":"Coronary artery bypass, vein only; 6 or more coronary venous grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2354.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1730","name":"Cath, ep, 19 or few elect","description":"Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33883","name":"Delayed plmt prox xtn prosth","description":"Delayed placement of proximal extension prosthesis(es) not involving coverage of the left subclavian artery origin, after endovascular repair of the thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and inter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44385","name":"Endoscopy of bowel pouch","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93721","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81234","name":"Dmpk gene detc abnor allele","description":"Dmpk (dm1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97002","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11056","name":"Parng/cutg b9 hyprkr les 2-4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92316","name":"C-lens fitg tech aphakia ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84578","name":"Test urine urobilinogen","description":"Urobilinogen, urine; qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7671.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0549T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93295","name":"Dev interrog remote 1/2/mlt","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41112","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; anterior two-thirds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47362","name":"Repair liver wound","description":"Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86606","name":"Aspergillus antibody","description":"Antibody; aspergillus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84378","name":"Sugars single quant","description":"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49565","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4403.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88305","name":"Tissue exam by pathologist","description":"Level iv - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone marrow, biopsy bone exostosis brain/meninges, other than for tumor resection breast, biopsy, not requiring microscopic evaluation of surgical margins breast, reduction mammoplasty bronc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13374.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90876","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 45 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33231","name":"Insrt pulse gen w/mult leads","description":"Insertion of implantable defibrillator pulse generator only; with existing multiple leads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25116","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27385","name":"Repair of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; primary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95125","name":"Immunotherapy 2/> injections","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 or more injections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82728","name":"Assay of ferritin","description":"Ferritin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80400","name":"Acth stimulation panel","description":"Acth stimulation panel; for adrenal insufficiency this panel must include the following: cortisol (82533 x 2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35671","name":"Bpg pop-tibl/-prnl artery","description":"Bypass graft, with other than vein; popliteal-tibial or -peroneal artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46940","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87205","name":"Smear gram stain","description":"Smear, primary source with interpretation; gram or giemsa stain for bacteria, fungi, or cell types","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6404","name":"Sterile gauze > 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32668","name":"Thoracoscopy w/w resect diag","description":"Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80196","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32220","name":"Release of lung","description":"Decortication, pulmonary (separate procedure); total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22612","name":"Arthrd pst tq 1ntrspc lumbar","description":"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9143","name":"Warfarin respon genetic test","description":"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63015","name":"Remove spine lamina >2 crvcl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57265","name":"Cmbn ap colprhy w/ntrcl rpr","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43850","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55875","name":"Transperi needle place pros","description":"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47556","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) with stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4714","name":"Treated water per gallon","description":"Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41874","name":"Alveoloplasty each quadrant","description":"Alveoloplasty, each quadrant (specify)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11622","name":"Exc s/n/h/f/g mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35022","name":"Repair artery rupture chest","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0396","name":"Alcohol/subs interv 15-30mn","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23397","name":"Muscle transfers","description":"Muscle transfer, any type, shoulder or upper arm; multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4161","name":"Ef ped hydrolyzed/amino acid","description":"Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32501","name":"Repair bronchus add-on","description":"Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1730","name":"Cath, ep, 19 or few elect","description":"Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83951","name":"Oncoprotein dcp","description":"Oncoprotein; des-gamma-carboxy-prothrombin (dcp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6256","name":"Absorpt drg > 48 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15200","name":"Fth/gft fr trnk 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31595","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23605","name":"Cltx prx hmrl fx mnpj+-tract","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32420","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24515","name":"Optx humrl shft fx plate/scr","description":"Open treatment of humeral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70558","name":"Mri brain w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80420","name":"Dexamethasone panel","description":"Dexamethasone suppression panel, 48 hour this panel must include the following: free cortisol, urine (82530 x 2) cortisol (82533 x 2) volume measurement for timed collection (81050 x 2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21172","name":"Rcnst supr-lat orb rm&lw fhd","description":"Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1899.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21048","name":"Remove maxilla cyst complex","description":"Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4676.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57100","name":"Biopsy vaginal mucosa simple","description":"Biopsy of vaginal mucosa; simple (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4523","name":"Adult size brief/diaper lg","description":"Adult sized disposable incontinence product, brief/diaper, large, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0295T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32666","name":"Thoracoscopy w/wedge resect","description":"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7900","name":"Male vacuum erection system","description":"Male vacuum erection system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45020","name":"Drainage of rectal abscess","description":"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61538","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24670","name":"Cltx ulnar fx prox w/o mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8778.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11450","name":"Exc skn hdrdnt ax smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61860","name":"Implant neuroelectrodes","description":"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43338","name":"Esoph lengthening","description":"Esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33620","name":"Apply r&l pulm art bands","description":"Application of right and left pulmonary artery bands (eg, hybrid approach stage 1)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27592","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; open, circular (guillotine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27427","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; extra-articular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12037","name":"Intmd rpr s/tr/ext >30.0 cm","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21740","name":"Reconstruction of sternum","description":"Reconstructive repair of pectus excavatum or carinatum; open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43328","name":"Esoph fundoplasty thor","description":"Esophagogastric fundoplasty partial or complete; thoracotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4155","name":"Ef incomplete/modular","description":"Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 un","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19366","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33986","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33746","name":"Tis cgen car anomal ea addl","description":"Transcatheter intracardiac shunt (tis) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44369","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84702","name":"Chorionic gonadotropin test","description":"Gonadotropin, chorionic (hcg); quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12013","name":"Rpr f/e/e/n/l/m 2.6-5.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20900","name":"Removal of bone for graft","description":"Bone graft, any donor area; minor or small (eg, dowel or button)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37185","name":"Prim art m-thrmbc sbsq vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (list separa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8555.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5183.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15151","name":"Tis cltr skn agrft t/a/l add","description":"Tissue cultured skin autograft, trunk, arms, legs; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15732","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9278","name":"External receiver, cgm sys","description":"Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62280","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21160","name":"Rcnst mdfc lfrtiii advm w/i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"24120","name":"Exc/crtg b1 cst/b9 tum rds","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33266","name":"Ablate atria x10sv endo","description":"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4627","name":"Spacer bag/reservoir","description":"Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64520","name":"N block lumbar/thoracic","description":"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1501.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8427","name":"Ready gradient glove","description":"Gradient pressure aid (glove), ready made","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35682","name":"Composite byp grft 2 veins","description":"Bypass graft; autogenous composite, 2 segments of veins from 2 locations (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61500","name":"Crnec exc tum/bone les skull","description":"Craniectomy; with excision of tumor or other bone lesion of skull","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25575","name":"Optx rdl&uln shft fx rds&uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius and ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42320","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary, external","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26445","name":"Release hand/finger tendon","description":"Tenolysis, extensor tendon, hand or finger, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33264","name":"Rmvl & rplcmt dfb gen mlt ld","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58321","name":"Artificial insemination","description":"Artificial insemination; intra-cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17283","name":"Dstr mal ls f/e/e/n/l/m2.1-3","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61635","name":"Intracran angioplsty w/stent","description":"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94644","name":"Cont inhlj tx 1st hour","description":"Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92652","name":"Aep thrshld est mlt freq i&r","description":"Auditory evoked potentials; for threshold estimation at multiple frequencies, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64653","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4874.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27472","name":"Repair/graft of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12055","name":"Intmd rpr face/mm 12.6-20 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36820","name":"Av fusion/forearm vein","description":"Arteriovenous anastomosis, open; by forearm vein transposition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92326","name":"Replacement of contact lens","description":"Replacement of contact lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99191","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); 45 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27501","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28086","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; flexor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49062","name":"Drain to peritoneal cavity","description":"Drainage of extraperitoneal lymphocele to peritoneal cavity, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"67570","name":"Decompress optic nerve","description":"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"61107","name":"Tdh pnxr implt ventr cath","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20102","name":"Expl pentrg wnd abd/flnk/bk","description":"Exploration of penetrating wound (separate procedure); abdomen/flank/back","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45391","name":"Colonoscopy w/endoscope us","description":"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27130","name":"Total hip arthroplasty","description":"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28020","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83008","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11462","name":"Exc skn hdrdnt ing smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37140","name":"Revision of circulation","description":"Venous anastomosis, open; portocaval","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85445","name":"Heinz bodies induced","description":"Heinz bodies; induced, acetyl phenylhydrazine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63194","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"L3265","name":"Plastazote sandal each","description":"Plastazote sandal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15115","name":"Epdrm agrft f/s/n/h/f/g/m 1","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24675","name":"Cltx ulnar fx prox w/mnpj","description":"Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21296","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43310","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98943","name":"Chiropract manj xtrspinl 1/>","description":"Chiropractic manipulative treatment (cmt); extraspinal, 1 or more regions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49590","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"19001","name":"Puncture aspir cyst brst ea","description":"Puncture aspiration of cyst of breast; each additional cyst (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68328","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65286","name":"Repair of eye wound","description":"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81420","name":"Fetal chrmoml aneuploidy","description":"Fetal chromosomal aneuploidy (eg, trisomy 21, monosomy x) genomic sequence analysis panel, circulating cell-free fetal dna in maternal blood, must include analysis of chromosomes 13, 18, and 21","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4810.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99226","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44960","name":"Appendectomy","description":"Appendectomy; for ruptured appendix with abscess or generalized peritonitis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64484","name":"Njx aa&/strd tfrm epi l/s ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15946","name":"Exc isch pr ulc prep mus flp","description":"Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24546","name":"Optx hum fx w/ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondylar extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75680","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22634","name":"Arthrd cmbn 1ntrspc ea addl","description":"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (list separately in addition to code for prima","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38765","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4533","name":"Youth size brief/diaper","description":"Youth sized disposable incontinence product, brief/diaper, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25077","name":"Resect forearm/wrist tum<3cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0440","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97140","name":"Manual therapy 1/> regions","description":"Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3102.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27830","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4081","name":"Enteral ng tubing w/ stylet","description":"Nasogastric tubing with stylet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36145","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47135","name":"Transplantation of liver","description":"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41821","name":"Excision of gum flap","description":"Operculectomy, excision pericoronal tissues","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92651","name":"Aep hearing status deter i&r","description":"Auditory evoked potentials; for hearing status determination, broadband stimuli, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44625","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7529.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96118","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96361","name":"Hydrate iv infusion add-on","description":"Intravenous infusion, hydration; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31297","name":"Nsl/sins ndsc surg sphn sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33608","name":"Repair anomaly w/conduit","description":"Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3615.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57520","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33916","name":"Surgery of great vessel","description":"Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3695.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63091","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23472","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95836","name":"Ecog impltd brn npgt <30 d","description":"Electrocorticogram from an implanted brain neurostimulator pulse generator/transmitter, including recording, with interpretation and written report, up to 30 days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68020","name":"Incise/drain eyelid lining","description":"Incision of conjunctiva, drainage of cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15157","name":"Tis clt agrft f/s/n/h/f/g ea","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28293","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0296","name":"Visit to determ ldct elig","description":"Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99235","name":"Hosp ip/obs same date mod 70","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encount","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0197T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25275","name":"Repair forearm tendon sheath","description":"Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (eg, for extensor carpi ulnaris subluxation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64625","name":"Rf abltj nrv nrvtg si jt","description":"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34201","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44383","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26676","name":"Pin hand dislocation","description":"Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90880","name":"Hypnotherapy","description":"Hypnotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0248","name":"Demonstrate use home inr mon","description":"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22511","name":"Perq lumbosacral injection","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52332","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46270","name":"Remove anal fist subq","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64488","name":"Tap block bi injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99418","name":"Prolng ip/obs e/m ea 15 min","description":"Prolonged inpatient or observation evaluation and management service(s) time with or without direct patient contact beyond the required time of the primary service when the primary service level has been selected using total time, each 15 minutes of total time (list separately in addition to the cod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99423","name":"Ol dig e/m svc 21+ min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21215","name":"Lower jaw bone graft","description":"Graft, bone; mandible (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37218","name":"Stent placemt ante carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50825","name":"Construct bowel bladder","description":"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (kock pouch or camey enterocystoplasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31652","name":"Bronch ebus samplng 1/2 node","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23332","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62148","name":"Retr bone flap to fix skull","description":"Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28545","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82784","name":"Assay iga/igd/igg/igm each","description":"Gammaglobulin (immunoglobulin); iga, igd, igg, igm, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43253","name":"Egd us transmural injxn/mark","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duoden","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55876","name":"Place rt device/marker pros","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78591","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86481","name":"Tb ag response t-cell susp","description":"Tuberculosis test, cell mediated immunity antigen response measurement; enumeration of gamma interferon-producing t-cells in cell suspension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9490","name":"Cmmi mod home visit","description":"Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/man","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4652","name":"Microcapillary tube sealant","description":"Microcapillary tube sealant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34808","name":"Endovas iliac a device addon","description":"Endovascular placement of iliac artery occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32562","name":"Lyse chest fibrin subq day","description":"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); subsequent day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0509","name":"Crit care telehea consult 50","description":"Telehealth consultation, critical care, subsequent, physicians typically spend 50 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0104","name":"Ca screen;flexi sigmoidscope","description":"Colorectal cancer screening; flexible sigmoidoscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67010","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77423","name":"Neutron beam tx complex","description":"High energy neutron radiation treatment delivery, 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11960","name":"Insert tissue expander(s)","description":"Insertion of tissue expander(s) for other than breast, including subsequent expansion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33984","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33684","name":"Clsr 1 vsd w/wo patch w/vlvt","description":"Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32556","name":"Insert cath pleura w/o image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60240","name":"Removal of thyroid","description":"Thyroidectomy, total or complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11387.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58270","name":"Vag hyst w/enterocele repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93592","name":"Perq transcath closure each","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6402.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33782","name":"Nikaidoh proc","description":"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, nikaidoh procedure); without coronary ostium reimplantation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43775","name":"Lap sleeve gastrectomy","description":"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4220","name":"Infusion pump refill kit","description":"Refill kit for implantable infusion pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90999","name":"Unlisted dialysis procedure","description":"Unlisted dialysis procedure, inpatient or outpatient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33641","name":"Repair heart septum defect","description":"Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33505","name":"Repair artery w/tunnel","description":"Repair of anomalous coronary artery from pulmonary artery origin; with construction of intrapulmonary artery tunnel (takeuchi procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57425","name":"Laparoscopy surg colpopexy","description":"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15420","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88241","name":"Frozen cell preparation","description":"Thawing and expansion of frozen cells, each aliquot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50225","name":"Removal kidney open complex","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93567","name":"Njx car cth sprvlv aortgrphy","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32486","name":"Sleeve lobectomy","description":"Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1525.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32668","name":"Thoracoscopy w/w resect diag","description":"Thoracoscopy, surgical; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95070","name":"Inhlj brncl challenge tstg","description":"Inhalation bronchial challenge testing (not including necessary pulmonary function tests), with histamine, methacholine, or similar compounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57426","name":"Revise prosth vag graft lap","description":"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41805","name":"Removal foreign body gum","description":"Removal of embedded foreign body from dentoalveolar structures; soft tissues","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37253","name":"Intrvasc us noncoronary addl","description":"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3512.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"89050","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37766","name":"Phleb veins - extrem 20+","description":"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0016","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32603","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13131","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2860","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68130","name":"Exc les conjunctiva adj scl","description":"Excision of lesion, conjunctiva; with adjacent sclera","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25675","name":"Cltx dstl rad/uln dislc mnpj","description":"Closed treatment of distal radioulnar dislocation with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4199","name":"Parenteral sol > 100gm prote","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, over 100 grams of protein - premix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90815","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96001","name":"Motion test w/ft press meas","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics; with dynamic plantar pressure measurements during walking","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23550","name":"Optx acromclv dislc aqt/chrn","description":"Open treatment of acromioclavicular dislocation, acute or chronic;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12057","name":"Intmd rpr face/mm >30.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23552","name":"Optx acrclv dslc aq/chrn grf","description":"Open treatment of acromioclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64495","name":"Inj paravert f jnt l/s 3 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0555","name":"Humidifier for use w/ regula","description":"Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4463.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85613","name":"Russell viper venom diluted","description":"Russell viper venom time (includes venom); diluted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3010.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99188","name":"App topical fluoride varnish","description":"Application of topical fluoride varnish by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32445","name":"Removal of lung extrapleural","description":"Removal of lung, pneumonectomy; extrapleural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34820","name":"Opn iliac art expos","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66984","name":"Xcapsl ctrc rmvl w/o ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57288","name":"Repair bladder defect","description":"Sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4036","name":"Enteral feed sup kit grav by","description":"Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50728","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37700","name":"Ligation&div long saph vein","description":"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52300","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3079.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97034","name":"App mdlty 1+cntrst bth ea 15","description":"Application of a modality to 1 or more areas; contrast baths, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44360","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35251","name":"Rpr blvsl vn grf intra-abdl","description":"Repair blood vessel with vein graft; intra-abdominal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3995.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41108","name":"Biopsy of floor of mouth","description":"Biopsy of floor of mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33266","name":"Ablate atria x10sv endo","description":"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure), without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99244","name":"Off/op cnsltj new/est mod 40","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31800","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0456","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27615","name":"Resect leg/ankle tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64898","name":"Nrv grf mltst arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94777","name":"Ped home apnea mntr rvw i&r","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; review, interpretation and preparation of report only by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47562","name":"Laparoscopic cholecystectomy","description":"Laparoscopy, surgical; cholecystectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20005","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21014","name":"Exc face tum deep 2 cm/>","description":"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11006","name":"Dbrdmt skin xtrnl gent per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26121","name":"Release palm contracture","description":"Fasciectomy, palm only, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95936","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33404","name":"Prepare heart-aorta conduit","description":"Construction of apical-aortic conduit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21433","name":"Optx cranfcl sep comp mlt","description":"Open treatment of craniofacial separation (lefort iii type); complicated (eg, comminuted or involving cranial nerve foramina), multiple surgical approaches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7313.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L9900","name":"O&p supply/accessory/service","description":"Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs l code","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92019","name":"Lmtd oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5844.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54322","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, magpi, v-flap)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99451","name":"Ntrprof ph1/ntrnet/ehr 5/>","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a written report to the patients treating/requesting physician or other qualified health care professional, 5 mi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33422","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; open heart, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44015","name":"Insert needle cath bowel","description":"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (list separately in addition to primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38300","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4397","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2753.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63655","name":"Implant neuroelectrodes","description":"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33814","name":"Obltrj a-pulm sep def w/byp","description":"Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6260","name":"Wound cleanser any type/size","description":"Wound cleansers, any type, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21122","name":"Geniop sldg osteot 2/>","description":"Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35484","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37617","name":"Ligation major artery abd","description":"Ligation, major artery (eg, post-traumatic, rupture); abdomen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83904","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2748.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61314","name":"Crnec/crnot ittl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33536","name":"Cabg arterial four or more","description":"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2297.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26608","name":"Treat metacarpal fracture","description":"Percutaneous skeletal fixation of metacarpal fracture, each bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19086","name":"Bx breast add lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01632","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25337","name":"Reconstruct ulna/radioulnar","description":"Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99252","name":"Ip/obs consltj new/est sf 35","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27445","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25675","name":"Cltx dstl rad/uln dislc mnpj","description":"Closed treatment of distal radioulnar dislocation with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22100","name":"Remove part of neck vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43265","name":"Ercp lithotripsy calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26415","name":"Excision hand/finger tendon","description":"Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64714","name":"Revise low back nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50065","name":"Nl sec surg operj calculus","description":"Nephrolithotomy; secondary surgical operation for calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98967","name":"Ph1 assmt&mgmt nqhp 11-20","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27416","name":"Osteochondral knee autograft","description":"Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0213T","name":"Njx paravert w/us cer/thor","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45384","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85347","name":"Coagulation time activated","description":"Coagulation time; activated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28119","name":"Removal of heel spur","description":"Ostectomy, calcaneus; for spur, with or without plantar fascial release","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8421","name":"Ready gradient sleev/glov","description":"Gradient pressure aid (sleeve and glove combination), ready made","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20610","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0378T","name":"Visual field assmnt rev/rprt","description":"Visual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22856","name":"Tot disc arthrp 1ntrspc crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83909","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49900","name":"Repair of abdominal wall","description":"Suture, secondary, of abdominal wall for evisceration or dehiscence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4158","name":"Ef ped complete intact nut","description":"Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91312","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83912","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0427","name":"Inpt/ed teleconsult70","description":"Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75996","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21346","name":"Opn tx nasomax fx w/fixj","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with wiring and/or local fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81539","name":"Oncology prostate prob score","description":"Oncology (high-grade prostate cancer), biochemical assay of four proteins (total psa, free psa, intact psa, and human kallikrein-2 [hk2]), utilizing plasma or serum, prognostic algorithm reported as a probability score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11303","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter over 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11201","name":"Rmvl skin tags ea addl 10","description":"Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37600","name":"Ligation xtrnl carotid art","description":"Ligation; external carotid artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32422","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21360","name":"Opn tx dprsd malar fracture","description":"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93656","name":"Compre ep eval abltj atr fib","description":"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including left or right atrial pacing/recording, and intracardiac catheter ablation of atrial fibrillation by ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92975","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50387","name":"Change nephroureteral cath","description":"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92314","name":"C-lens fitg tech ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0440T","name":"Abltj perc uxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22610","name":"Arthrd pst tq 1ntrspc thrc","description":"Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38208","name":"Thaw preserved stem cells","description":"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, without washing, per donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87477","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41116","name":"Excision of mouth lesion","description":"Excision, lesion of floor of mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26567","name":"Correct finger deformity","description":"Osteotomy; phalanx of finger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20560","name":"Ndl insj w/o njx 1 or 2 musc","description":"Needle insertion(s) without injection(s); 1 or 2 muscle(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4508.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33321","name":"Repair major vessel","description":"Suture repair of aorta or great vessels; with shunt bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45135","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15937","name":"Exc sac pr ulc prep mus ostc","description":"Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37238","name":"Open/perq place stent same","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3152.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0198T","name":"Ocular blood flow measure","description":"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36479","name":"Endovenous laser vein addon","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24435","name":"Rpr non/mal hum with agrft","description":"Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15933","name":"Exc sac pr ulc prim str ostc","description":"Excision, sacral pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87207","name":"Smear special stain","description":"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26720","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87277","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36901","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93568","name":"Njx car cth nslc p-art angrp","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78591","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80424","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for pheochromocytoma this panel must include the following: catecholamines, fractionated (82384 x 2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87582","name":"M.pneumon dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G3003","name":"Chronic pain mgmt addl 15m","description":"Each additional 15 minutes of chronic pain management and treatment by a physician or other qualified health care professional, per calendar month. (list separately in addition to code for g3002. when using g3003, 15 minutes must be met or exceeded.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61751","name":"Brain biopsy w/ct/mr guide","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5012.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69020","name":"Drg xtrnl aud canal abscess","description":"Drainage external auditory canal, abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58100","name":"Biopsy of uterus lining","description":"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44050","name":"Reduce bowel obstruction","description":"Reduction of volvulus, intussusception, internal hernia, by laparotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87339","name":"H pylori ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"Esrd srv 2-3 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per mo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27137","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59121","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33414","name":"Repair of aortic valve","description":"Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99144","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29828","name":"Sho arthrs srg bicp tenodsis","description":"Arthroscopy, shoulder, surgical; biceps tenodesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4553.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65420","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67101","name":"Repair detached retina crtx","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64566","name":"Neuroeltrd stim post tibial","description":"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35482","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43117","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (ivor lewis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15610","name":"Delay flap arms/legs","description":"Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61542","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24164","name":"Removal prosth radial head","description":"Removal of prosthesis, includes debridement and synovectomy when performed; radial head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93503","name":"Insert/place heart catheter","description":"Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2000.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33948","name":"Ecmo/ecls daily mgmt-venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-venous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36216","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64787","name":"Implant nerve end","description":"Implantation of nerve end into bone or muscle (list separately in addition to neuroma excision)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29904","name":"Subtalar arthro w/fb rmvl","description":"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37183","name":"Revision tips","description":"Revision of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract recannulization/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66630","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31540","name":"Laryngoscopy w/exc of tumor","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"66987","name":"Xcapsl ctrc rmvl cplx w/ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86905","name":"Blood typing rbc antigens","description":"Blood typing, serologic; rbc antigens, other than abo or rh (d), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34471","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; subclavian vein, by neck incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9604","name":"One-way allow prorated trip","description":"Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"98977","name":"Rtm dev sply mscskl 16-30 d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33362","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open femoral artery approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96113","name":"Devel tst phys/qhp ea addl","description":"Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34451","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2340.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33864","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling (eg, david procedure, yacoub procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36248","name":"Ins cath abd/l-ext art addl","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96155","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26480","name":"Transplant hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62282","name":"Treat spinal canal lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86294","name":"Immunoassay tumor qual","description":"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54700","name":"I&d epdidyms tstis&/scrot sp","description":"Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90804","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41828","name":"Excision of gum lesion","description":"Excision of hyperplastic alveolar mucosa, each quadrant (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63660","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"81284","name":"Fxn gene detc abnor alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3818","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7076.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87801","name":"Detect agnt mult dna ampli","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; amplified probe(s) technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17263","name":"Dstrj mal les t/a/l 2.1-3.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60521","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75722","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96118","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9482","name":"Remote e/m new pt 20mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination;  straightforward medical decis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23000","name":"Rmvl sbdltd clcreous dep opn","description":"Removal of subdeltoid calcareous deposits, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4657.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6200","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33572","name":"Open coronary endarterectomy","description":"Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (list separately in addition to primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4363.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0455","name":"Fecal microbiota prep instil","description":"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93236","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92314","name":"C-lens fitg tech ou","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90857","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61313","name":"Crnec/crnot sttl icere","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1811.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62201","name":"Brain cavity shunt w/scope","description":"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83661","name":"L/s ratio fetal lung","description":"Fetal lung maturity assessment; lecithin sphingomyelin (l/s) ratio","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92547","name":"Supplemental electrical test","description":"Use of vertical electrodes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0511","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86765","name":"Rubeola antibody","description":"Antibody; rubeola","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93463","name":"Drug admin & hemodynmic meas","description":"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed (list separately in addition to","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9870","name":"Cmmi asyntelehealth >20min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5980.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57531","name":"Removal of cervix radical","description":"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87327","name":"Cryptococcus neoform ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptococcus neoformans","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83919","name":"Organic acids qual each","description":"Organic acids; qualitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78268","name":"Urea breath test c-14 alys","description":"Urea breath test, c-14 (isotopic); analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15261","name":"Fth/gft fr n/e/e/l each addl","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0197T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2465.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87250","name":"Virus inoculate eggs/animal","description":"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12018","name":"Rpr f/e/e/n/l/m >30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2291","name":"Planar back for ped size wc","description":"Back, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87272","name":"Cryptosporidium ag if","description":"Infectious agent antigen detection by immunofluorescent technique; cryptosporidium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38215","name":"Harvest stem cell concentrte","description":"Transplant preparation of hematopoietic progenitor cells; cell concentration in plasma, mononuclear, or buffy coat layer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"Nubhvl xm phys/qhp 1st hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2530.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49083","name":"Abd paracentesis w/imaging","description":"Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4306","name":"Drug delivery system <=50 ml","description":"Disposable drug delivery system, flow rate of less than 50 ml per hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54352","name":"Revj prior hypspad repair","description":"Revision of prior hypospadias repair requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3311.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87535","name":"Hiv-1 probe&reverse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33220","name":"Repair lead pace-defib dual","description":"Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27532","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0426","name":"Inpt/ed teleconsult50","description":"Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27001","name":"Tenotomy adductor hip open","description":"Tenotomy, adductor of hip, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49654","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92591","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54324","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33953","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15240","name":"Fth/gft f/c/c/m/n/ax/g/h/f20","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22527","name":"Idet 1 or more levels","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1907.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21040","name":"Excise mandible lesion","description":"Excision of benign tumor or cyst of mandible, by enucleation and/or curettage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35363","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0247T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26951","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62145","name":"Repair of skull & brain","description":"Cranioplasty for skull defect with reparative brain surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84182","name":"Protein western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64580","name":"Opn impltj nea neuromuscular","description":"Open implantation of neurostimulator electrode array; neuromuscular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3799.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31591","name":"Laryngoplasty medialization","description":"Laryngoplasty, medialization, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54417","name":"Remv/replc penis pros compl","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19286","name":"Perq dev breast add us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0328","name":"Ped hospital bed, manual","description":"Hospital bed, pediatric, manual, 360 degree side enclosures, top of headboard, footboard and side rails up to 24 inches above the spring, includes mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0442T","name":"Abltj perc plex/trncl nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0042T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21432","name":"Optx cranfcl sep w/wiring","description":"Open treatment of craniofacial separation (lefort iii type); with wiring and/or internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31292","name":"Nsl/sins ndsc med/inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4162","name":"Ef ped specmetabolic inherit","description":"Enteral formula, for pediatrics, special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43244","name":"Egd varices ligation","description":"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49652","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3401.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"67112","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49402","name":"Remove foreign body adbomen","description":"Removal of peritoneal foreign body from peritoneal cavity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1825","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99446","name":"Ntrprof ph1/ntrnet/ehr 5-10","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37606","name":"Lig int/com carotid art occl","description":"Ligation; internal or common carotid artery, with gradual occlusion, as with selverstone or crutchfield clamp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24665","name":"Optx radial head/neck fx","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8879.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84410","name":"Testosterone bioavailable","description":"Testosterone; bioavailable, direct measurement (eg, differential precipitation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9561","name":"Tc99m oxidronate","description":"Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82608","name":"B-12 binding capacity","description":"Cyanocobalamin (vitamin b-12); unsaturated binding capacity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86741","name":"Neisseria meningitidis","description":"Antibody; neisseria meningitidis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33405","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27742","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; and distal femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3952.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93539","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35685","name":"Bypass graft patency/patch","description":"Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5429.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80417","name":"Renin stimulation panel","description":"Peripheral vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32671","name":"Thoracoscopy pneumonectomy","description":"Thoracoscopy, surgical; with removal of lung (pneumonectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43865","name":"Revj gstr/jj anast w/vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11730","name":"Avulsion nail plate simple 1","description":"Avulsion of nail plate, partial or complete, simple; single","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11730","name":"Avulsion nail plate simple 1","description":"Avulsion of nail plate, partial or complete, simple; single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36823","name":"Insertion of cannula(s)","description":"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) and repair of arteriotomy and venotomy sites","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62148","name":"Retr bone flap to fix skull","description":"Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0610","name":"Annual gynecological examina","description":"Annual gynecological examination, new patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"65285","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0078","name":"Care manag h vst new pt 45 m","description":"Moderate (45 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3219","name":"Orthopedic mens shoes oxford","description":"Orthopedic footwear, mens shoe, oxford, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4719","name":"Y set tubing","description":"Y set tubing for peritoneal dialysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27067","name":"Remove/graft hip bone lesion","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; with autograft requiring separate incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78588","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43108","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29582","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43360","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65778","name":"Cover eye w/membrane","description":"Placement of amniotic membrane on the ocular surface; without sutures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49653","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27831","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8839.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23675","name":"Cltx sho dislc neck fx mnpj","description":"Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27680","name":"Release of lower leg tendon","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19287","name":"Perq dev breast 1st mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43820","name":"Gastrojejunostomy wo vagotmy","description":"Gastrojejunostomy; without vagotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52315","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92617","name":"Fees w/laryngeal sense i&r","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2643.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87301","name":"Adenovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; adenovirus enteric types 40/41","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87532","name":"Hhv-6 dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47382","name":"Percut ablate liver rf","description":"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35666","name":"Bpg fem-ant tib pst tib/prnl","description":"Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44365","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15953","name":"Exc trchntr pr ulc flp ostc","description":"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43648","name":"Lap revise/remv eltrd antrum","description":"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3211","name":"Surgical boot each junior","description":"Surgical boot, each, junior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25442","name":"Arthrp w/prostc dstl ulna","description":"Arthroplasty with prosthetic replacement; distal ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4189","name":"Parenteral sol amino acid &","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 10 to 51 grams of protein - premix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9868","name":"Cmmi asyntelehealth <10min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50405","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20705","name":"Rmvl i-artic rx delivery dev","description":"Removal of drug-delivery device(s), intra-articular (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0281","name":"Elec stim unattend for press","description":"Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1840.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58750","name":"Repair oviduct","description":"Tubotubal anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20701","name":"Rmvl deep rx delivery device","description":"Removal of drug-delivery device(s), deep (eg, subfascial) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50120","name":"Pyelotomy w/exploration","description":"Pyelotomy; with exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25315","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87540","name":"Legion pneumo dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62367","name":"Analyze spine infus pump","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming or refill","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54300","name":"Revision of penis","description":"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0071","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51798","name":"Us urine capacity measure","description":"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3819","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15772","name":"Grfg autol fat lipo ea addl","description":"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36596","name":"Mech remov tunneled cv cath","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33256","name":"Ablate atria w/bypass exten","description":"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95832","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5610.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86906","name":"Bld typing serologic rh phnt","description":"Blood typing, serologic; rh phenotyping, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36830","name":"Artery-vein nonautograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2055.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19300","name":"Mastectomy for gynecomastia","description":"Mastectomy for gynecomastia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94005","name":"Home vent mgmt supervision","description":"Home ventilator management care plan oversight of a patient (patient not present) in home, domiciliary or rest home (eg, assisted living) requiring review of status, review of laboratories and other studies and revision of orders and respiratory care plan (as appropriate), within a calendar month, 3","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26545","name":"Reconstruct finger joint","description":"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49185","name":"Sclerotx fluid collection","description":"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"17282","name":"Dstr mal ls f/e/e/n/l/m1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49450","name":"Replace g/c tube perc","description":"Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4157","name":"Ef special metabolic inherit","description":"Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27681","name":"Release of lower leg tendons","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incision[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7274","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86920","name":"Compatibility test spin","description":"Compatibility test each unit; immediate spin technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32124","name":"Explore chest free adhesions","description":"Thoracotomy; with open intrapleural pneumonolysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27130","name":"Total hip arthroplasty","description":"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85220","name":"Blooc clot factor v test","description":"Clotting; factor v (acg or proaccelerin), labile factor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3141.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24073","name":"Ex arm/elbow tum deep 5 cm/>","description":"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0145","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63020","name":"Lamot dcmprn nrv rt 1 cerv","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69602","name":"Rev mstdc rslt mod rad mstdc","description":"Revision mastoidectomy; resulting in modified radical mastoidectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11462","name":"Exc skn hdrdnt ing smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61651","name":"Evasc prlng admn rx agnt add","description":"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92370","name":"Rpr&refitg spect xcp aphakia","description":"Repair and refitting spectacles; except for aphakia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90812","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93582","name":"Perq transcath closure pda","description":"Percutaneous transcatheter closure of patent ductus arteriosus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35045","name":"Repair defect of arm artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9489","name":"Remote e/m est. pt 40mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision makin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80192","name":"Assay of procainamide","description":"Procainamide; with metabolites (eg, n-acetyl procainamide)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9432.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50953","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12036","name":"Intmd rpr s/a/t/ext 20.1-30","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15793","name":"Chemical peel nonfacial drm","description":"Chemical peel, nonfacial; dermal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70549","name":"Mr angiograph neck w/o&w/dye","description":"Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23075","name":"Exc shoulder les sc < 3 cm","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63076","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2252.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23040","name":"Arthrt gh jt expl/drg/rmv fb","description":"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27446","name":"Revision of knee joint","description":"Arthroplasty, knee, condyle and plateau; medial or lateral compartment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28150","name":"Removal of toe","description":"Phalangectomy, toe, each toe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93797","name":"Phys/qhp op car rhab wo ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; without continuous ecg monitoring (per session)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26530","name":"Revise knuckle joint","description":"Arthroplasty, metacarpophalangeal joint; each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33572","name":"Open coronary endarterectomy","description":"Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99306","name":"1st nf care high mdm 50","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes must be met or exceed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50686","name":"Measure ureter pressure","description":"Manometric studies through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22102","name":"Remove part lumbar vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37616","name":"Ligation major artery chest","description":"Ligation, major artery (eg, post-traumatic, rupture); chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0249","name":"Provide inr test mater/equip","description":"Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33987","name":"Artery expos/graft artery","description":"Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ecmo/ecls (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["AW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61641","name":"Dilat ic vspsm ea vsl sm ter","description":"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67210","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","AV","AU","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27509","name":"Treatment of thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or without intercondylar extension, or distal femoral epiphyseal separation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36581","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19564.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96110","name":"Developmental screen w/score","description":"Developmental screening (eg, developmental milestone survey, speech and language delay screen), with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10180","name":"I&d complex po wound infctj","description":"Incision and drainage, complex, postoperative wound infection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0517T","name":"Insj wcs lv both compnt pg","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; both components of pulse generator (battery and transmitter) only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41805","name":"Removal foreign body gum","description":"Removal of embedded foreign body from dentoalveolar structures; soft tissues","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35141","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37232","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33270","name":"Ins/rep subq defibrillator","description":"Insertion or replacement of permanent subcutaneous implantable defibrillator system, with subcutaneous electrode, including defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic param","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86360","name":"T cell absolute count/ratio","description":"T cells; absolute cd4 and cd8 count, including ratio","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3095.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44397","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45114","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; abdominal and transsacral approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0502","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0207T","name":"Clear eyelid gland w/heat","description":"Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22556","name":"Arthrd ant ntrbd min dsc thc","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4090.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43501","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of bleeding ulcer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86153","name":"Cell enumeration phys interp","description":"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80502","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26607","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61642","name":"Dilat ic vspsm ea diff ter","description":"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63196","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26951","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67808","name":"Remove eyelid lesion(s)","description":"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25260","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0124","name":"Screen c/v thin layer by md","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44626","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, closure of hartmann type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27005","name":"Tenotomy hip flexor open","description":"Tenotomy, hip flexor(s), open (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85220","name":"Blooc clot factor v test","description":"Clotting; factor v (acg or proaccelerin), labile factor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87254","name":"Virus inoculation shell via","description":"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50945","name":"Laparoscopy ureterolithotomy","description":"Laparoscopy, surgical; ureterolithotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33726","name":"Repair pul venous stenosis","description":"Repair of pulmonary venous stenosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69717","name":"Rplcmt oi implt skl prq esp","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5100","name":"Parenteral solution hepatic","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85576","name":"Blood platelet aggregation","description":"Platelet, aggregation (in vitro), each agent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26551","name":"Great toe-hand transfer","description":"Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3506.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33412","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with transventricular aortic annulus enlargement (konno procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61590","name":"Infratemporal approach/skull","description":"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parotidectomy, craniotomy, decompression and/or mobilization of the facial nerve and/or petrous carotid a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2557.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87808","name":"Trichomonas assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; trichomonas vaginalis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11421","name":"Exc h-f-nk-sp b9+marg 0.6-1","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80152","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93720","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87561","name":"M.avium-intra dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32200","name":"Drain open lung lesion","description":"Pneumonostomy, with open drainage of abscess or cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51720","name":"Treatment of bladder lesion","description":"Bladder instillation of anticarcinogenic agent (including retention time)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50562","name":"Renal scope w/tumor resect","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43773","name":"Lap replace gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of adjustable gastric restrictive device component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86378","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3216","name":"Orthoped ladies shoes dpth i","description":"Orthopedic footwear, ladies shoe, depth inlay, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20100","name":"Expl pentrg wound neck","description":"Exploration of penetrating wound (separate procedure); neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5717.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15922","name":"Exc coccygl pr ulc flap clsr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0248","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87636","name":"Sarscov2 & inf a&b amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) and influenza virus types a and b, multiplex amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0200T","name":"Perq sacral augmt unilat inj","description":"Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98971","name":"Nqhp ol dig assmt&mgmt 11-20","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31529","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28005","name":"Treat foot bone lesion","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33954","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33960","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57505","name":"Endocervical curettage","description":"Endocervical curettage (not done as part of a dilation and curettage)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0281","name":"Elec stim unattend for press","description":"Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67105","name":"Repair detached retina pc","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63048","name":"Lam facetec &foramot ea addl","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional vertebral segment, cervical, thoracic, or lumbar (list separately in addition t","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86353","name":"Lymphocyte transformation","description":"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36228","name":"Place cath intracranial art","description":"Selective catheter placement, each intracranial branch of the internal carotid or vertebral arteries, unilateral, with angiography of the selected vessel circulation and all associated radiological supervision and interpretation (eg, middle cerebral artery, posterior inferior cerebellar artery) (lis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9603","name":"One-way allow prorated miles","description":"Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27132","name":"Total hip arthroplasty","description":"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87501","name":"Influenza dna amp prob 1+","description":"Infectious agent detection by nucleic acid (dna or rna); influenza virus, includes reverse transcription, when performed, and amplified probe technique, each type or subtype","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81272","name":"Kit gene targeted seq analys","description":"Kit (v-kit hardy-zuckerman 4 feline sarcoma viral oncogene homolog) (eg, gastrointestinal stromal tumor [gist], acute myeloid leukemia, melanoma), gene analysis, targeted sequence analysis (eg, exons 8, 11, 13, 17, 18)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3249.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11786.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37565","name":"Ligation int jugular vein","description":"Ligation, internal jugular vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0502","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44370","name":"Small bowel endoscopy/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64718","name":"Revise ulnar nerve at elbow","description":"Neuroplasty and/or transposition; ulnar nerve at elbow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0055T","name":"Bone srgry cmptr ct/mri imag","description":"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on ct/mri images (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4575","name":"Hyperbaric o2 chamber disps","description":"Topical hyperbaric oxygen chamber, disposable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21930","name":"Exc back les sc < 3 cm","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50329","name":"Prep renal graft/ureteral","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10243.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10368.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93592","name":"Perq transcath closure each","description":"Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27513","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15336","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37209","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82486","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81166","name":"Brca1 gene full dup/del alys","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99607","name":"Mtms by pharm addl 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65778","name":"Cover eye w/membrane","description":"Placement of amniotic membrane on the ocular surface; without sutures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0296T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0468T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27027","name":"Dcmprn fasct pel compartment","description":"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43237","name":"Endoscopic us exam esoph","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01632","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86789","name":"West nile virus antibody","description":"Antibody; west nile virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34802","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99335","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20611","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43249","name":"Esoph egd dilation <30 mm","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3340.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41512","name":"Tongue suspension","description":"Tongue base suspension, permanent suture technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3899.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65260","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20005","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54115","name":"Treatment of penis lesion","description":"Removal foreign body from deep penile tissue (eg, plastic implant)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2005","name":"Post-d/c h vst new pt 75 m","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44361","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11721","name":"Debride nail 6 or more","description":"Debridement of nail(s) by any method(s); 6 or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27059","name":"Resect hip/pelv tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96910","name":"Photchmtx tar&uvb/ptrltm&uvb","description":"Photochemotherapy; tar and ultraviolet b (goeckerman treatment) or petrolatum and ultraviolet b","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27240","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28805","name":"Amputation thru metatarsal","description":"Amputation, foot; transmetatarsal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64505","name":"N block spenopalatine gangl","description":"Injection, anesthetic agent; sphenopalatine ganglion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34832","name":"Open aortofemor prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15770","name":"Derma-fat-fascia graft","description":"Graft; derma-fat-fascia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95132","name":"Immntx 3 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 3 stinging insect venoms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20985","name":"Cptr-asst dir ms px","description":"Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22841","name":"Insert spine fixation device","description":"Internal spinal fixation by wiring of spinous processes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52317","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0518T","name":"Rmvl pg wcs lv battery only","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; battery component only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50340","name":"Recipient nephrectomy","description":"Recipient nephrectomy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77412","name":"Radiation tx delivery lvl 3","description":"Radiation treatment delivery; level 3, multiple isocenters with photon therapy (eg, 2d, 3d, or imrt) or a single-isocenter photon therapy (eg, 3d or imrt) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21179","name":"Rcnstj forehead with grafts","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33995","name":"Insj perq vad r hrt venous","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; right heart, venous access only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89320","name":"Semen anal vol/count/mot","description":"Semen analysis; volume, count, motility, and differential","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21175","name":"Rcnst bfrnt sp orb rm&lw fhd","description":"Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35631","name":"Bpg aor-celiac-msn-renal","description":"Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58974","name":"Embryo transfer intrauterine","description":"Embryo transfer, intrauterine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"90889","name":"Preparation of report","description":"Preparation of report of patients psychiatric status, history, treatment, or progress (other than for legal or consultative purposes) for other individuals, agencies, or insurance carriers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90476","name":"Adenovirus vaccine type 4","description":"Adenovirus vaccine, type 4, live, for oral use","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58152","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, marshall-marchetti-krantz, burch)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9983","name":"Remote e/m est. pt 10mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86741","name":"Neisseria meningitidis","description":"Antibody; neisseria meningitidis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95132","name":"Immntx 3 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 3 stinging insect venoms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69643","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0329","name":"Electromagntic tx for ulcers","description":"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57308","name":"Fistula repair transperine","description":"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31647","name":"Bronchial valve init insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57180","name":"Treat vaginal bleeding","description":"Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2260.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37251","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8680","name":"Implt neurostim elctr each","description":"Implantable neurostimulator electrode, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3306.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11104","name":"Punch bx skin single lesion","description":"Punch biopsy of skin (including simple closure, when performed); single lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27059","name":"Resect hip/pelv tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87337","name":"Entamoeb hist group ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica group","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29834","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42810","name":"Excision of neck cyst","description":"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11960","name":"Insert tissue expander(s)","description":"Insertion of tissue expander(s) for other than breast, including subsequent expansion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5706.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37191","name":"Ins endovas vena cava filtr","description":"Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65436","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with application of chelating agent (eg, edta)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89105","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46221","name":"Ligation of hemorrhoid(s)","description":"Hemorrhoidectomy, internal, by rubber band ligation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61720","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4519.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2005.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86941","name":"Hemolysins/agglutinins","description":"Hemolysins and agglutinins; incubated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87305","name":"Aspergillus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; aspergillus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28546","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43405","name":"Ligate/staple esophagus","description":"Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49582","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78434","name":"Aqmbf pet rest & rx stress","description":"Absolute quantitation of myocardial blood flow (aqmbf), positron emission tomography (pet), rest and pharmacologic stress (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13153","name":"Cmplx rpr e/n/e/l addl 5cm/<","description":"Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31628","name":"Bronchoscopy/lung bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33233","name":"Removal of pm generator","description":"Removal of permanent pacemaker pulse generator only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44158","name":"Colectomy w/neo-rectum pouch","description":"Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal reservoir (s or j), includes loop ileostomy, and rectal mucosectomy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4300","name":"Cath impl vasc access portal","description":"Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55700","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45520","name":"Treatment of rectal prolapse","description":"Perirectal injection of sclerosing solution for prolapse","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1887.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20979","name":"Lw ntsty us stimj bone healg","description":"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4100","name":"Food thickener oral","description":"Food thickener, administered orally, per ounce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36245","name":"Ins cath abd/l-ext art 1st","description":"Selective catheter placement, arterial system; each first order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33866","name":"Aortic hemiarch graft","description":"Aortic hemiarch graft including isolation and control of the arch vessels, beveled open distal aortic anastomosis extending under one or more of the arch vessels, and total circulatory arrest or isolated cerebral perfusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48120","name":"Removal of pancreas lesion","description":"Excision of lesion of pancreas (eg, cyst, adenoma)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"B4149","name":"Ef blenderized foods","description":"Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1940.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21330","name":"Open tx nose fx w/skele fixj","description":"Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61586","name":"Resect nasopharynx skull","description":"Bicoronal, transzygomatic and/or lefort i osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49491","name":"Rpr hern preemie reduc","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12037","name":"Intmd rpr s/tr/ext >30.0 cm","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42831","name":"Removal of adenoids","description":"Adenoidectomy, primary; age 12 or over","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89055","name":"Leukocyte assessment fecal","description":"Leukocyte assessment, fecal, qualitative or semiquantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7769.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46744","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58952","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25110","name":"Remove wrist tendon lesion","description":"Excision, lesion of tendon sheath, forearm and/or wrist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14001","name":"Tis trnfr trunk 10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67218","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81187","name":"Cnbp gene detc abnor allele","description":"Cnbp (cchc-type zinc finger nucleic acid binding protein) (eg, myotonic dystrophy type 2) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96165","name":"Hlth bhv ivntj grp ea addl","description":"Health behavior intervention, group (2 or more patients), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38221","name":"Dx bone marrow biopsies","description":"Diagnostic bone marrow; biopsy(ies)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28606","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1815","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64610","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62294","name":"Injection into spinal artery","description":"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59076","name":"Fetal shunt placement w/us","description":"Fetal shunt placement, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3257","name":"Orth foot add charge split s","description":"Orthopedic footwear, additional charge for split size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49215","name":"Excise sacral spine tumor","description":"Excision of presacral or sacrococcygeal tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84403","name":"Assay of total testosterone","description":"Testosterone; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45805","name":"Repair fistula w/colostomy","description":"Closure of rectovesical fistula; with colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63086","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45309","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84704","name":"Hcg free betachain test","description":"Gonadotropin, chorionic (hcg); free beta chain","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88261","name":"Chromosome analysis 5","description":"Chromosome analysis; count 5 cells, 1 karyotype, with banding","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99377","name":"Hospice care supervision","description":"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52356","name":"Cysto/uretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4088","name":"Gastro/jejuno tube, low-pro","description":"Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4606","name":"Oxygen probe used w oximeter","description":"Oxygen probe for use with oximeter device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27638","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33330","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67346","name":"Biopsy eye muscle","description":"Biopsy of extraocular muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62380","name":"Ndsc dcmprn 1 ntrspc lumbar","description":"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G6008","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57105","name":"Biopsy vaginal mucosa xtnsv","description":"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21127","name":"Augmentation mndblr b1 grf","description":"Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34203","name":"Removal of leg artery clot","description":"Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43238","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11426","name":"Exc h-f-nk-sp b9+marg >4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4057.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16384.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36400","name":"Vnpnxr<3yrs phy/qhp fem/jug","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5241","name":"Dispensing fee, monaural","description":"Dispensing fee, monaural hearing aid, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45381","name":"Colonoscopy submucous njx","description":"Colonoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33202","name":"Insert epicard eltrd open","description":"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85540","name":"Wbc alkaline phosphatase","description":"Leukocyte alkaline phosphatase with count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5072.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2842.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4641","name":"Radiopharm dx agent noc","description":"Radiopharmaceutical, diagnostic, not otherwise classified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43647","name":"Lap impl electrode antrum","description":"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94761","name":"N-invas ear/pls oximetry mlt","description":"Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37229","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11604","name":"Exc tr-ext mal+marg 3.1-4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74340","name":"X-ray guide for gi tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott), including multiple fluoroscopies and images, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G2213","name":"Initiat med assist tx in er","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"H2019","name":"Ther behav svc, per 15 min","description":"Therapeutic behavioral services, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["U4"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59856","name":"Induced ab 1+vag supp d&c","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64405","name":"Njx aa&/strd gr ocpl nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52007","name":"Cysto urtrl cathj brush bx","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3250","name":"Custom mold shoe remov prost","description":"Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32097","name":"Open wedge/bx lung nodule","description":"Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81285","name":"Fxn gene charac alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38760","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, including cloquets node (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"Vnpnxr<3yrs phy/qhp scalp vn","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; scalp vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93786","name":"Ambl bp mntr w/sw rec only","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; recording only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26820","name":"Thumb fusion with graft","description":"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37618","name":"Ligation major artery xtr","description":"Ligation, major artery (eg, post-traumatic, rupture); extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83912","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34717","name":"Evasc rpr a-iliac ndgft","description":"Endovascular repair of iliac artery at the time of aorto-iliac artery endograft placement by deployment of an iliac branched endograft including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radiological supervision and interpret","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94012","name":"Spirmtry w/brnchdil inf-2 yr","description":"Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33535","name":"Cabg arterial three","description":"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26645","name":"Treat thumb fracture","description":"Closed treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61705","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89136","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41115","name":"Excision of tongue fold","description":"Excision of lingual frenum (frenectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2114.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64893","name":"Nrv grf 1strnd arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46706","name":"Repr of anal fistula w/glue","description":"Repair of anal fistula with fibrin glue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35484","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75722","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94004","name":"Vent mgmt nf per day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; nursing facility, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57550","name":"Removal of residual cervix","description":"Excision of cervical stump, vaginal approach;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4301","name":"Implantable access syst perc","description":"Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15366","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33471","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22548","name":"Arthrd ant toral/xoral c1-c2","description":"Arthrodesis, anterior transoral or extraoral technique, clivus-c1-c2 (atlas-axis), with or without excision of odontoid process","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36478","name":"Endovenous laser 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80100","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54060","name":"Excision of penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61556","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; frontal or parietal bone flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61885","name":"Insrt/redo neurostim 1 array","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15935","name":"Exc sac pr ulc skn flp ostc","description":"Excision, sacral pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36584","name":"Compl rplcmt picc rs&i","description":"Replacement, complete, of a peripherally inserted central venous catheter (picc), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45400","name":"Laparoscopic proc","description":"Laparoscopy, surgical; proctopexy (for prolapse)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20932","name":"Osteoart algrft w/surf & b1","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64402","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88143","name":"Cytopath c/v thin layer redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2295.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84080","name":"Assay alkaline phosphatases","description":"Phosphatase, alkaline; isoenzymes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33840","name":"Exc coa w/direct anastomosis","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49587","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50690","name":"Injection for ureter x-ray","description":"Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92014","name":"Compre oph exam est pt 1/>","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27356","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97610","name":"Low frequency non-thermal us","description":"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58957","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21180","name":"Rcnstj forehead w/autograft","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27334","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior or posterior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20962","name":"Other bone graft microvasc","description":"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55520","name":"Removal of sperm cord lesion","description":"Excision of lesion of spermatic cord (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49327","name":"Lap ins device for rt","description":"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (list separately in addition to code for primary proced","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33619","name":"Repair single ventricle","description":"Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, norwood procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"33822","name":"Repair pda div<18 years","description":"Repair of patent ductus arteriosus; by division, younger than 18 years","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99156","name":"Mod sed oth phys/qhp 5/>yrs","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 year","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4673","name":"Ext line w easy lock connect","description":"Extension line with easy lock connectors, used with dialysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32560","name":"Treat pleurodesis w/agent","description":"Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent or persistent pneumothorax)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3141.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98972","name":"Nqhp ol dig assmt&mgmt 21+","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29828","name":"Sho arthrs srg bicp tenodsis","description":"Arthroscopy, shoulder, surgical; biceps tenodesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15732","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"89051","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83902","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33274","name":"Tcat insj/rpl perm ldls pm","description":"Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38525","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep axillary node(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32540","name":"Removal of lung lesion","description":"Extrapleural enucleation of empyema (empyemectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50580","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11012","name":"Deb skin bone at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64581","name":"Opn impltj nea sacral nerve","description":"Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96137","name":"Psycl/nrpsyc tst phy/qhp ea","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99415","name":"Prolng clin staff svc 1st hr","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; first hour (list separately in addition to code for out","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99245","name":"Off/op consltj new/est hi 55","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31552","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31625","name":"Bronchoscopy w/biopsy(s)","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63090","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1712.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60254","name":"Extensive thyroid surgery","description":"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0245T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27177","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3485","name":"Shoe heel pad removable for","description":"Heel, pad, removable for spur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81020","name":"Urinalysis glass test","description":"Urinalysis; 2 or 3 glass test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26518","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 3 or 4 digits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24500","name":"Cltx humrl shft fx w/o mnpj","description":"Closed treatment of humeral shaft fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89331","name":"Retrograde ejaculation anal","description":"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9484","name":"Remote e/m new pt 45mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35881","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46735","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0435","name":"Oral hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29125","name":"Appl short arm splint static","description":"Application of short arm splint (forearm to hand); static","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4158.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12052","name":"Intmd rpr face/mm 2.6-5.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49557","name":"Rerepair fem hernia blocked","description":"Repair recurrent femoral hernia; incarcerated or strangulated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21810","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33224","name":"Insert pacing lead & connect","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of existing generator)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21159","name":"Rcnst mdfc lfrtiii advm wo i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29850","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93508","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97124","name":"Massage therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61710","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28272","name":"Release of toe joint each","description":"Capsulotomy; interphalangeal joint, each joint (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G2088","name":"Off base opioid tx, add30","description":"Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55000","name":"Drainage of hydrocele","description":"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2342.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57156","name":"Ins vag brachytx device","description":"Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2250","name":"Remot img sub by pt, non e/m","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or p","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11422","name":"Exc h-f-nk-sp b9+marg 1.1-2","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2515.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47542","name":"Dilate biliary duct/ampulla","description":"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"80101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27632","name":"Exc leg/ankle les sc 3 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98966","name":"Ph1 assmt&mgmt nqhp 5-10","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63064","name":"Decompress spinal cord thrc","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44715","name":"Prepare donor intestine","description":"Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63688","name":"Rev/rmv imp sp npg/r dtch cn","description":"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93463","name":"Drug admin & hemodynmic meas","description":"Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed (list separately in addition to","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92586","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0200T","name":"Perq sacral augmt unilat inj","description":"Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21045","name":"Extensive jaw surgery","description":"Excision of malignant tumor of mandible; radical resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49500","name":"Rpr ing hernia init reduce","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86256","name":"Fluorescent antibody titer","description":"Fluorescent noninfectious agent antibody; titer, each antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58240","name":"Removal of pelvis contents","description":"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12052","name":"Intmd rpr face/mm 2.6-5.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5577.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33018","name":"Prcrd drg 0-5yr or w/anomly","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; birth through 5 years of age or any age with congenital cardiac anomaly","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9561","name":"Tc99m oxidronate","description":"Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27600","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6702.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6019","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16025","name":"Dress/debrid p-thick burn m","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47550","name":"Bile duct endoscopy add-on","description":"Biliary endoscopy, intraoperative (choledochoscopy) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36217","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial third order or more selective thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5008","name":"Hearing screening","description":"Hearing screening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"57180","name":"Treat vaginal bleeding","description":"Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"22841","name":"Insert spine fixation device","description":"Internal spinal fixation by wiring of spinous processes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94761","name":"N-invas ear/pls oximetry mlt","description":"Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27762","name":"Cltx med ankle fx w/mnpj","description":"Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43246","name":"Egd place gastrostomy tube","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15834","name":"Exc excessive skin hip","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90460","name":"Im admin 1st/only component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first or only component of each vaccine or toxoid administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1870.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83498","name":"Asy hydroxyprogesterone 17-d","description":"Hydroxyprogesterone, 17-d","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46761","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (park posterior anal repair)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516T","name":"Insj wcs lv eltrd only","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; electrode only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21244","name":"Reconstruction of lower jaw","description":"Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31561","name":"Larynscop remve cart + scop","description":"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36582","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9487","name":"Remote e/m est. pt 15mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33406","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62268","name":"Drain spinal cord cyst","description":"Percutaneous aspiration, spinal cord cyst or syrinx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35651","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21935","name":"Resect back tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11603","name":"Exc tr-ext mal+marg 2.1-3 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51715","name":"Endoscopic injection/implant","description":"Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1995.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27329","name":"Resect thigh/knee tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43846","name":"Gstr rstcv px shrt roux-en-y","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) roux-en-y gastroenterostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86309","name":"Heterophile antibody titer","description":"Heterophile antibodies; titer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61686","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21557","name":"Resect neck thorax tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54348","name":"Rpr hypspad comp dsj & urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring extensive dissection, and urethroplasty with flap, patch or tubed graft (including urinary diversion, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36514","name":"Apheresis plasma","description":"Therapeutic apheresis; for plasma pheresis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11403","name":"Exc tr-ext b9+marg 2.1-3cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92002","name":"Intrm oph exam new patient","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54318","name":"Reconstruction of urethra","description":"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage cecil repair)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33987","name":"Artery expos/graft artery","description":"Arterial exposure with creation of graft conduit (eg, chimney graft) to facilitate arterial perfusion for ecmo/ecls (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87520","name":"Hepatitis c rna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85345","name":"Coagulation time lee & white","description":"Coagulation time; lee and white","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0019","name":"Comm hlth intg svs sdoh 60mn","description":"Community health integration services performed by certified or trained auxiliary personnel, including a community health worker, under the direction of a physician or other practitioner; 60 minutes per calendar month, in the following activities to address social determinants of health (sdoh) need(","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51596","name":"Remove bladder/create pouch","description":"Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93229","name":"Remote 30 day ecg tech supp","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11100","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68325","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4589.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64490","name":"Inj paravert f jnt c/t 1 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4564.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67430","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4736.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31515","name":"Laryngoscopy for aspiration","description":"Laryngoscopy direct, with or without tracheoscopy; for aspiration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"56420","name":"I&d bartholins gland abscess","description":"Incision and drainage of bartholins gland abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24006","name":"Arthrt elbw capsl exc rls","description":"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63016","name":"Remove spine lamina >2 thrc","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54112","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft greater than 5 cm in length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43228","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43840","name":"Gstrrphy sutr duol/gstr ulcr","description":"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87512","name":"Gardner vag dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86744","name":"Nocardia antibody","description":"Antibody; nocardia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11100","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50398","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92625","name":"Tinnitus assessment","description":"Assessment of tinnitus (includes pitch, loudness matching, and masking)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14302","name":"Tis trnfr addl 30 sq cm","description":"Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27781","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26372","name":"Repair/graft hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1870.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97597","name":"Dbrdmt opn wnd 1st 20 cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82507","name":"Assay of citrate","description":"Citrate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96371","name":"Sc ther infusion reset pump","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65870","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17000","name":"Destruct premalg lesion","description":"Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28313","name":"Repair deformity of toe","description":"Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47765","name":"Fuse liver ducts & bowel","description":"Anastomosis, of intrahepatic ducts and gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"96151","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88363","name":"Xm archive tissue molec anal","description":"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89060","name":"Exam synovial fluid crystals","description":"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65779","name":"Cover eye w/membrane suture","description":"Placement of amniotic membrane on the ocular surface; single layer, sutured","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21080","name":"Impres&prep def obt prosth","description":"Impression and custom preparation; definitive obturator prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21485","name":"Cltx tmprmand dislc comp","description":"Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4534.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26135","name":"Revise finger joint each","description":"Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0474T","name":"Insj aqueous drg dev io rsvr","description":"Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43361","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22522","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"14001","name":"Tis trnfr trunk 10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21230","name":"Rib cartilage graft","description":"Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2084.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25025","name":"Decompress forearm 2 spaces","description":"Decompression fasciotomy, forearm and/or wrist, flexor and extensor compartment; with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62141","name":"Crnop skull defect>5 cm diam","description":"Cranioplasty for skull defect; larger than 5 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29730","name":"Windowing of cast","description":"Windowing of cast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24500","name":"Cltx humrl shft fx w/o mnpj","description":"Closed treatment of humeral shaft fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99082","name":"Unusual physician travel","description":"Unusual travel (eg, transportation and escort of patient)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78584","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24371","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36592","name":"Collect blood from picc","description":"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29740","name":"Wedging of cast","description":"Wedging of cast (except clubfoot casts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75676","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66770","name":"Removal of inner eye lesion","description":"Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33864","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root remodeling (eg, david procedure, yacoub procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2809.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15003","name":"Wound prep addl 100 cm","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20664","name":"Appl halo cranial 6+pins","description":"Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31612","name":"Perq trchl pnxr ttrach aspir","description":"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27658","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21440","name":"Cltx mndblr/max alv ridge fx","description":"Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54060","name":"Excision of penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87530","name":"Hsv dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64420","name":"Njx aa&/strd ntrcost nrv 1","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0508","name":"Crit care telehea consult 60","description":"Telehealth consultation, critical care, initial , physicians typically spend 60 minutes communicating with the patient and providers via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27110","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to greater trochanter of femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21209","name":"Reduction of facial bones","description":"Osteoplasty, facial bones; reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1548.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92627","name":"Eval aud funcj ea addl 15","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); each additional 15 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83905","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63077","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64643","name":"Chemodenerv 1 extrem 1-4 ea","description":"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34151","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11047","name":"Dbrdmt bone each addl","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82360","name":"Calculus assay quant","description":"Calculus; quantitative analysis, chemical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64577","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21077","name":"Impres&prep orbital prosth","description":"Impression and custom preparation; orbital prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"21600","name":"Partial removal of rib","description":"Excision of rib, partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35636","name":"Bpg splenorenal","description":"Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64416","name":"Njx aa&/strd brch pl nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54660","name":"Revision of testis","description":"Insertion of testicular prosthesis (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29846","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35549","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78465","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5097.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24116","name":"Exc/crtg b1 cst/tum hum algr","description":"Excision or curettage of bone cyst or benign tumor, humerus; with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43278","name":"Ercp lesion ablate w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with ablation of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37211","name":"Thrombolytic art therapy","description":"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82615","name":"Test for urine cystines","description":"Cystine and homocystine, urine, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64870","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1753","name":"Cath, intravas ultrasound","description":"Catheter, intravascular ultrasound","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33367","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35152","name":"Repair ruptd popliteal art","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, popliteal artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61536","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2710.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40652","name":"Rpr lip fth<half ver height","description":"Repair lip, full thickness; up to half vertical height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57500","name":"Biopsy of cervix","description":"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25574","name":"Optx rdl&uln shft fx rds/uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius or ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35132","name":"Repair artery rupture groin","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery (common, hypogastric, external)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25565","name":"Cltx rdl&uln shft fx w/mnpj","description":"Closed treatment of radial and ulnar shaft fractures; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87149","name":"Dna/rna direct probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, direct probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25075","name":"Exc forearm les sc < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96361","name":"Hydrate iv infusion add-on","description":"Intravenous infusion, hydration; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4818.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57556","name":"Remove cervix repair bowel","description":"Excision of cervical stump, vaginal approach; with repair of enterocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49407","name":"Image cath fluid trns/vgnl","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92943","name":"Prq trluml revsc ch occ ant","description":"Percutaneous transluminal revascularization of chronic total occlusion, single coronary artery, coronary artery branch, or coronary artery bypass graft, and/or subtended major coronary artery branches of the bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; antegrade","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98960","name":"Edu&trn pt self-mgmt nqhp 1","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87283","name":"Rubeola ag if","description":"Infectious agent antigen detection by immunofluorescent technique; rubeola","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90828","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64783","name":"Limb nerve surgery add-on","description":"Excision of neuroma; hand or foot, each additional nerve, except same digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45315","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33697","name":"Compl rpr tof w/pulm atresia","description":"Complete repair tetralogy of fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and closure of ventricular septal defect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86709","name":"Hepatitis a igm antibody","description":"Hepatitis a antibody (haab), igm antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24151","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81001","name":"Urinalysis auto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57020","name":"Colpocentesis sep px","description":"Colpocentesis (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64553","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; cranial nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58546","name":"Laparo-myomectomy complex","description":"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77372","name":"Srs linear based","description":"Radiation treatment delivery, stereotactic radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27860","name":"Fixation of ankle joint","description":"Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61322","name":"Crnec/crnot dcmprv w/o lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64595","name":"Rev/rmv prph sac/gstr npg/r","description":"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3000.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2657.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41150","name":"Tongue mouth jaw surgery","description":"Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15934","name":"Exc sacral pr ulc skn flap","description":"Excision, sacral pressure ulcer, with skin flap closure;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26432","name":"Repair finger tendon","description":"Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1894","name":"Intro/sheath, non-laser","description":"Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28043","name":"Exc foot/toe tum sc < 1.5 cm","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36593","name":"Declot vascular device","description":"Declotting by thrombolytic agent of implanted vascular access device or catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00622","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5971.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36660","name":"Insertion catheter artery","description":"Catheterization, umbilical artery, newborn, for diagnosis or therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61586","name":"Resect nasopharynx skull","description":"Bicoronal, transzygomatic and/or lefort i osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2530.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99324","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37224","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1722.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58541","name":"Lsh uterus 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1441.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0430","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2848.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43762","name":"Rplc gtube no revj trc","description":"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33990","name":"Insj perq vad l hrt arterial","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29075","name":"Appl cst elbw fngr short arm","description":"Application, cast; elbow to finger (short arm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36516","name":"Apheresis immunoads slctv","description":"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3060.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54205","name":"Njx px peyronie ds exps plaq","description":"Injection procedure for peyronie disease; with surgical exposure of plaque","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1762.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26432","name":"Repair finger tendon","description":"Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86832","name":"Hla class i high defin qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), hla class i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64627","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32554","name":"Aspirate pleura w/o imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92626","name":"Eval aud funcj 1st hour","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69222","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24066","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15850","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22328","name":"Treat each add spine fx","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"57260","name":"Cmbn ant pst colprhy","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25671","name":"Perq skel fix rad/uln dislc","description":"Percutaneous skeletal fixation of distal radioulnar dislocation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58605","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31554","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68750","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33976","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33990","name":"Insj perq vad l hrt arterial","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33016","name":"Pericardiocentesis w/imaging","description":"Pericardiocentesis, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0710","name":"Restraints any type","description":"Restraints, any type (body, chest, wrist or ankle)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27370","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43253","name":"Egd us transmural injxn/mark","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (eg, anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duoden","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33017","name":"Prcrd drg 6yr+ w/o cgen car","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; 6 years and older without congenital cardiac anomaly","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"55880","name":"Abltj mal prst8 tiss hifu","description":"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20934","name":"Intercalary algrft compl","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary, complete (ie, cylindrical) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67030","name":"Incise inner eye strands","description":"Discission of vitreous strands (without removal), pars plana approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3152.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61510","name":"Crnec treph exc brn tum sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78588","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15776","name":"Hair trnspl >15 punch grafts","description":"Punch graft for hair transplant; more than 15 punch grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95984","name":"Alys brn npgt prgrmg addl 15","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61720","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28300","name":"Incision of heel bone","description":"Osteotomy; calcaneus (eg, dwyer or chambers type procedure), with or without internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35636","name":"Bpg splenorenal","description":"Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45550","name":"Repair rectum/remove sigmoid","description":"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89055","name":"Leukocyte assessment fecal","description":"Leukocyte assessment, fecal, qualitative or semiquantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27570","name":"Fixation of knee joint","description":"Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49521","name":"Rerepair ing hernia blocked","description":"Repair recurrent inguinal hernia, any age; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74713","name":"Mri fetal ea addl gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4525","name":"Adult size pull-on sm","description":"Adult sized disposable incontinence product, protective underwear/pull-on, small size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86817","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, multiple antigens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11950","name":"Subq njx filling matrl 1cc/<","description":"Subcutaneous injection of filling material (eg, collagen); 1 cc or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82307","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36218","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; additional second order, third order, and beyond, thoracic or brachiocephalic branch, within a vascular family (list in addition to code for initial second or third order vessel as appropriate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36261","name":"Revision of infusion pump","description":"Revision of implanted intra-arterial infusion pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68810","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33271","name":"Insj subq impltbl dfb elctrd","description":"Insertion of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78587","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67445","name":"Explr/decompress eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of bone for decompression","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3292.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92620","name":"Auditory function 60 min","description":"Evaluation of central auditory function, with report; initial 60 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88372","name":"Protein analysis w/probe","description":"Protein analysis of tissue by western blot, with interpretation and report; immunological probe for band identification, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60522","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92603","name":"Cochlear implt f/up exam 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; with programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11622","name":"Exc s/n/h/f/g mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33261","name":"Ablate heart dysrhythm focus","description":"Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91012","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54401","name":"Insert self-contd prosthesis","description":"Insertion of penile prosthesis; inflatable (self-contained)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63035","name":"Lamot dcmprn nrv rt ea addl","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50327","name":"Prep renal graft/venous","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95831","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93784","name":"Ambl bp mntr w/software","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; including recording, scanning analysis, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90801","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94350","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43236","name":"Uppr gi scope w/submuc inj","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44370","name":"Small bowel endoscopy/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26551","name":"Great toe-hand transfer","description":"Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31551","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, younger than 12 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0637","name":"Combination sit to stand sys","description":"Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35483","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49553","name":"Rpr fem hernia init blocked","description":"Repair initial femoral hernia, any age; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4207","name":"2 cc sterile syringe&needle","description":"Syringe with needle, sterile 2 cc, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90824","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0214T","name":"Njx paravert w/us cer/thor","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57288","name":"Repair bladder defect","description":"Sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87197","name":"Serum bactericidal titer","description":"Serum bactericidal titer (schlichter test)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4929","name":"Tourniquet for dialysis, ea","description":"Tourniquet for dialysis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46285","name":"Remove anal fist 2 stage","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48155.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25446","name":"Arthrp w/prostc dst rds&crps","description":"Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64605","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33750","name":"Shunt subclavian to pulm art","description":"Shunt; subclavian to pulmonary artery (blalock-taussig type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"11044","name":"Dbrdmt bone 1st 20 sq cm/<","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42280","name":"Preparation palate mold","description":"Maxillary impression for palatal prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37211","name":"Thrombolytic art therapy","description":"Transcatheter therapy, arterial infusion for thrombolysis other than coronary or intracranial, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0431","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2249.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46060","name":"I&d ischiorectal/ntrmrl absc","description":"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25316","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist; with tendon(s) transfer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36909","name":"Dialysis circuit embolj","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95991","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed; requiring skill of a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92140","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36558","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33886","name":"Delayed plmt dstl xtn prosth","description":"Delayed placement of distal extension prosthesis(es) from the level of the left subclavian artery to the celiac artery, after endovascular repair of descending thoracic aorta, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological superv","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12044","name":"Intmd rpr n-hf/genit7.6-12.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62264","name":"Epidural lysis on single day","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 1 day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33984","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15341","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0241U","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93568","name":"Njx car cth nslc p-art angrp","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43350","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0118","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32561","name":"Lyse chest fibrin init day","description":"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61623","name":"Evasc temp balo artl occ h/n","description":"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiogra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31230","name":"Removal of upper jaw","description":"Maxillectomy; with orbital exenteration (en bloc)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22100","name":"Remove part of neck vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49654","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15833","name":"Exc excessive skin leg","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27632","name":"Exc leg/ankle les sc 3 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23120","name":"Claviculectomy partial","description":"Claviculectomy; partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0444T","name":"1st plmt drug elut oc ins","description":"Initial placement of a drug-eluting ocular insert under one or more eyelids, including fitting, training, and insertion, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88155","name":"Cytopath c/v index add-on","description":"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (list separately in addition to code[s] for other technical and interpretation services)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43233","name":"Egd balloon dil esoph30 mm/>","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25126","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49062","name":"Drain to peritoneal cavity","description":"Drainage of extraperitoneal lymphocele to peritoneal cavity, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82926","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7671.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32960","name":"Therapeutic pneumothorax","description":"Pneumothorax, therapeutic, intrapleural injection of air","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90827","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27842","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11471","name":"Exc skn h/p/p/u complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["BA","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87073","name":"Culture bacteria anaerobic","description":"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31087","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47542","name":"Dilate biliary duct/ampulla","description":"Balloon dilation of biliary duct(s) or of ampulla (sphincteroplasty), percutaneous, including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, each duct (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87107","name":"Fungi identification mold","description":"Culture, fungi, definitive identification, each organism; mold","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99307","name":"Sbsq nf care sf mdm 10","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met or e","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","AV","AU","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53425","name":"Reconstruct urethra stage 2","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4818.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35691","name":"Art trnsposj vertbrl carotid","description":"Transposition and/or reimplantation; vertebral to carotid artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4931","name":"Reusable oral thermometer","description":"Oral thermometer, reusable, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36818","name":"Av fuse uppr arm cephalic","description":"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15278","name":"Skn sub grft f/n/hf/g ch add","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22226","name":"Osteot dsc ant 1vrt sgm ea","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11950","name":"Subq njx filling matrl 1cc/<","description":"Subcutaneous injection of filling material (eg, collagen); 1 cc or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2324.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49451","name":"Replace duod/jej tube perc","description":"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19083","name":"Bx breast 1st lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4154","name":"Ef spec metabolic noninherit","description":"Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34151","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36476","name":"Endovenous rf vein add-on","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; subsequent vein(s) treated in a single extremity, each through separate access sites (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75671","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0055T","name":"Bone srgry cmptr ct/mri imag","description":"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on ct/mri images (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27598","name":"Amputate lower leg at knee","description":"Disarticulation at knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87526","name":"Hepatitis g dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64614","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10440.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"53601","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58275","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57135","name":"Excision vaginal cyst/tumor","description":"Excision of vaginal cyst or tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96111","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12054","name":"Intmd rpr face/mm 7.6-12.5cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99325","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43204","name":"Esoph scope w/sclerosis inj","description":"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93246","name":"Ext ecg>7d<15d recording","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; recording (includes connection and initial recording)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33502","name":"Coronary artery correction","description":"Repair of anomalous coronary artery from pulmonary artery origin; by ligation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28114","name":"Removal of metatarsal heads","description":"Ostectomy, complete excision; all metatarsal heads, with partial proximal phalangectomy, excluding first metatarsal (eg, clayton type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51590","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1569.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76150","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43847","name":"Gstr rstcv px sm int rcnstj","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1862.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31641","name":"Bronchoscopy treat blockage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95012","name":"Nitric oxide exp gas deter","description":"Nitric oxide expired gas determination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81528","name":"Oncology colorectal scr","description":"Oncology (colorectal) screening, quantitative real-time target and signal amplification of 10 dna markers (kras mutations, promoter methylation of ndrg4 and bmp3) and fecal hemoglobin, utilizing stool, algorithm reported as a positive or negative result","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27892","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44361","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81413","name":"Car ion chnnlpath inc 10 gns","description":"Cardiac ion channelopathies (eg, brugada syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing of at least 10 genes, including ank2, casq2, cav3, kcne1, kcne2, kcnh2, kcnj2, kcnq1, ryr2, and scn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21360","name":"Opn tx dprsd malar fracture","description":"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49520","name":"Rerepair ing hernia reduce","description":"Repair recurrent inguinal hernia, any age; reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","AV","AU","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38209","name":"Wash harvest stem cells","description":"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86243","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23540","name":"Cltx acromclav dislc wo mnpj","description":"Closed treatment of acromioclavicular dislocation; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67340","name":"Revise eye muscle add-on","description":"Strabismus surgery involving exploration and/or repair of detached extraocular muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47383","name":"Perq abltj lvr cryoablation","description":"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15101","name":"Splt agrft t/a/l ea addl 100","description":"Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1978.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63066","name":"Decompress spine cord add-on","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3296.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22310","name":"Closed tx vert fx w/o manj","description":"Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50700","name":"Revision of ureter","description":"Ureteroplasty, plastic operation on ureter (eg, stricture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44390","name":"Colonoscopy for foreign body","description":"Colonoscopy through stoma; with removal of foreign body(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99423","name":"Ol dig e/m svc 21+ min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93653","name":"Compre ep eval tx svt","description":"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording and catheter ablation of arrhythmogenic focus, including intracardiac electrophysiologic 3-dimensiona","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66130","name":"Remove eye lesion","description":"Excision of lesion, sclera","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67923","name":"Repair eyelid defect","description":"Repair of entropion; excision tarsal wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20527","name":"Njx nzm palmar fascial cord","description":"Injection, enzyme (eg, collagenase), palmar fascial cord (ie, dupuytrens contracture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67908","name":"Repair eyelid defect","description":"Repair of blepharoptosis; conjunctivo-tarso-mullers muscle-levator resection (eg, fasanella-servat type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66184","name":"Revision of aqueous shunt","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19324","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62160","name":"Neuroendoscopy add-on","description":"Neuroendoscopy, intracranial, for placement or replacement of ventricular catheter and attachment to shunt system or external drainage (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27479","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51920","name":"Close bladder-uterus fistula","description":"Closure of vesicouterine fistula;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96158","name":"Hlth bhv ivntj indiv 1st 30","description":"Health behavior intervention, individual, face-to-face; initial 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89136","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58952","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal tumors)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92523","name":"Speech sound lang comprehen","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31627","name":"Navigational bronchoscopy","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (list separately in addition to code for primary procedure[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26715","name":"Treat knuckle dislocation","description":"Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77403","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90868","name":"Tcranial magn stim tx deli","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent delivery and management, per session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93555","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50606","name":"Endoluminal bx urtr rnl plvs","description":"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35471","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21245","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0209T","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold), automated; air and bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9604","name":"One-way allow prorated trip","description":"Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36465","name":"Njx noncmpnd sclrsnt 1 vein","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; single incompetent extremity truncal vein (eg, great saphenous vein, accessory saphenous vein)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23802","name":"Arthrd glenohumeral jt w/grf","description":"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27692","name":"Revise additional leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35102","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8685","name":"Implt nrostm pls gen sng rec","description":"Implantable neurostimulator pulse generator, single array, rechargeable, includes extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0190","name":"Positioning cushion","description":"Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0071A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87385","name":"Histoplasma capsul ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; histoplasma capsulatum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96111","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0172T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58661","name":"Laparoscopy remove adnexa","description":"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33506","name":"Repair artery translocation","description":"Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27232","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0201T","name":"Perq sacral augmt bilat inj","description":"Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67560","name":"Revise eye socket implant","description":"Orbital implant (implant outside muscle cone); removal or revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3213","name":"Benesch boot pair child","description":"Benesch boot, pair, child","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32408","name":"Core ndl bx lng/med perq","description":"Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50435","name":"Exchange nephrostomy cath","description":"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66762","name":"Revision of iris","description":"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2472.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33770","name":"Rpr tga w/o surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92993","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29897","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68811","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57282","name":"Colpopexy extraperitoneal","description":"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54415","name":"Remove self-contd penis pros","description":"Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46275","name":"Remove anal fist inter","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50740","name":"Fusion of ureter & kidney","description":"Ureteropyelostomy, anastomosis of ureter and renal pelvis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67935","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81177","name":"Atn1 gene detc abnor alleles","description":"Atn1 (atrophin 1) (eg, dentatorubral-pallidoluysian atrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56632","name":"Vlvctmy rad prtl bi lymphad","description":"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29740","name":"Wedging of cast","description":"Wedging of cast (except clubfoot casts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1338.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82652","name":"Vit d 1 25-dihydroxy","description":"Vitamin d; 1, 25 dihydroxy, includes fraction(s), if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92071","name":"Contact lens fitting for tx","description":"Fitting of contact lens for treatment of ocular surface disease","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2368.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29891","name":"Arthr ank ostchn df tal&/tib","description":"Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83907","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9978","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a problem focused history; a problem focused examination; and strai","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21366","name":"Opn tx complx malar w/grft","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99446","name":"Ntrprof ph1/ntrnet/ehr 5-10","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12005","name":"Rpr s/n/a/gen/trk12.6-20.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33020","name":"Incision of heart sac","description":"Pericardiotomy for removal of clot or foreign body (primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61616","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; intradural, including dural repair, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63051","name":"C-laminoplasty w/graft/plate","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36822","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47140","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments ii and iii)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0457","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5329.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23077","name":"Rad rescj tum shoulder<5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56440","name":"Mrsplzatn brthlns glnd cst","description":"Marsupialization of bartholins gland cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92564","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4723","name":"Dialys sol fld vol > 2999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53235","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); male","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0104","name":"Ca screen;flexi sigmoidscope","description":"Colorectal cancer screening; flexible sigmoidoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29510.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69636","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21920","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43300","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65865","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51600","name":"Injection for bladder x-ray","description":"Injection procedure for cystography or voiding urethrocystography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53010","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1790.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30000","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal, internal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49203","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85280","name":"Clot factor xii hageman","description":"Clotting; factor xii (hageman)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25574","name":"Optx rdl&uln shft fx rds/uln","description":"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius or ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26725","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8387.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27488","name":"Removal of knee prosthesis","description":"Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89132","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87624","name":"Hpv hi-risk typ pooled rslt","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (eg, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), pooled result","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83904","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95706","name":"Eeg wo vid 2-12hr intmt mntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; with intermittent monitoring and maintenance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0321","name":"Audio-only hhs","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"64708","name":"Revise arm/leg nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80435","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for growth hormone deficiency this panel must include the following: glucose (82947 x 5) human growth hormone (hgh) (83003 x 5)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26352","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no mans land); secondary with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0422","name":"Intens cardiac rehab w/exerc","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0446T","name":"Insj impltbl glucose sensor","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88241","name":"Frozen cell preparation","description":"Thawing and expansion of frozen cells, each aliquot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4159","name":"Ef ped complete soy based","description":"Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51102","name":"Drain bl w/cath insertion","description":"Aspiration of bladder; with insertion of suprapubic catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31653","name":"Bronch ebus samplng 3/> node","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26117","name":"Rad resect hand tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83045","name":"Hgb methemoglobin qual","description":"Hemoglobin; methemoglobin, qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87260","name":"Adenovirus ag if","description":"Infectious agent antigen detection by immunofluorescent technique; adenovirus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28047","name":"Resect foot/toe tumor 3 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53661","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96164","name":"Hlth bhv ivntj grp 1st 30","description":"Health behavior intervention, group (2 or more patients), face-to-face; initial 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84220","name":"Assay of pyruvate kinase","description":"Pyruvate kinase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46930","name":"Destroy internal hemorrhoids","description":"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31628","name":"Bronchoscopy/lung bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90912","name":"Bfb training 1st 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27337","name":"Exc thigh/knee les sc 3 cm/>","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67025","name":"Replace eye fluid","description":"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4535","name":"Disposable liner/shield/pad","description":"Disposable liner/shield/guard/pad/undergarment, for incontinence, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54660","name":"Revision of testis","description":"Insertion of testicular prosthesis (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87140","name":"Culture type immunofluoresc","description":"Culture, typing; immunofluorescent method, each antiserum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67141","name":"Proph rta dtchmnt crtx dthrm","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86885","name":"Coombs test indirect qual","description":"Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22522","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4270.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57112","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42182","name":"Repair palate","description":"Repair, laceration of palate; over 2 cm or complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63664","name":"Revise spine eltrd plate","description":"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92640","name":"Aud brainstem implt programg","description":"Diagnostic analysis with programming of auditory brainstem implant, per hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21084","name":"Impres&prep sp aid prosth","description":"Impression and custom preparation; speech aid prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37184","name":"Prim art m-thrmbc 1st vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6416.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82487","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3076.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24300","name":"Mnpj elbow under anes","description":"Manipulation, elbow, under anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95983","name":"Alys brn npgt prgrmg 15 min","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0505","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99497","name":"Advncd care plan 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surroga","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64555","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3912.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93580","name":"Transcath closure of asd","description":"Percutaneous transcatheter closure of congenital interatrial communication (ie, fontan fenestration, atrial septal defect) with implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11643","name":"Exc f/e/e/n/l mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61596","name":"Transcochlear approach/skull","description":"Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35452","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95975","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9500","name":"Tc99m sestamibi","description":"Technetium tc-99m sestamibi, diagnostic, per study dose","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54161","name":"Circum 28 days or older","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4246","name":"Betadine/phisohex solution","description":"Betadine or phisohex solution, per pint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62281","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34001","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95718","name":"Eeg phys/qhp 2-12 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of eeg recording; with video (veeg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33391","name":"Valvuloplasty aortic valve","description":"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or annuloplasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96371","name":"Sc ther infusion reset pump","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); additional pump set-up with establishment of new subcutaneous infusion site(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27217","name":"Treat pelvic ring fracture","description":"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes pubic symphysis and/or ipsilateral superior/inferior rami)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62320","name":"Njx interlaminar crv/thrc","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58150","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46220","name":"Excise anal ext tag/papilla","description":"Excision of single external papilla or tag, anus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92020","name":"Gonioscopy","description":"Gonioscopy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29889","name":"Arthrs aid pcl rpr/agmntj","description":"Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22614","name":"Arthrd pst tq 1ntrspc ea add","description":"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24125","name":"Exc/crtg b1 cst/tum rds agrf","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36820","name":"Av fusion/forearm vein","description":"Arteriovenous anastomosis, open; by forearm vein transposition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61567","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9277","name":"External transmitter, cgm","description":"Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54405","name":"Insert multi-comp penis pros","description":"Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44205","name":"Lap colectomy part w/ileum","description":"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4207","name":"2 cc sterile syringe&needle","description":"Syringe with needle, sterile 2 cc, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37212","name":"Thrombolytic venous therapy","description":"Transcatheter therapy, venous infusion for thrombolysis, any method, including radiological supervision and interpretation, initial treatment day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0243","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27828","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both tibia and fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2855.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0498","name":"Chemo extend iv infus w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of infusion in the office/clinic setting using office/clinic pump/supplies, with continuation of the infusion in the community setting (e.g., home, domiciliary, rest home or assisted living) using a portable pump provided by the","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49507","name":"Prp i/hern init block >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58750","name":"Repair oviduct","description":"Tubotubal anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33767","name":"Shunt supr v/c p-art bth lng","description":"Shunt; superior vena cava to pulmonary artery for flow to both lungs (bidirectional glenn procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97110","name":"Therapeutic exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64461","name":"Pvb thoracic single inj site","description":"Paravertebral block (pvb) (paraspinous block), thoracic; single injection site (includes imaging guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71060","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33020","name":"Incision of heart sac","description":"Pericardiotomy for removal of clot or foreign body (primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80176","name":"Assay of lidocaine","description":"Lidocaine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19287","name":"Perq dev breast 1st mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67974","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93316","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19307","name":"Mast mod rad","description":"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24073","name":"Ex arm/elbow tum deep 5 cm/>","description":"Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28310","name":"Revision of big toe","description":"Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29584","name":"Appl mltlay cmprn sys up arm","description":"Application of multi-layer compression system; upper arm, forearm, hand, and fingers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99412","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64633","name":"Destroy cerv/thor facet jnt","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, single facet joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33257","name":"Ablate atria lmtd add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33859","name":"As-aort grf f/ds oth/thn dsj","description":"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic disease other than dissection (eg, aneurysm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86352","name":"Cell function assay w/stim","description":"Cellular function assay involving stimulation (eg, mitogen or antigen) and detection of biomarker (eg, atp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25071","name":"Exc forearm les sc 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49418","name":"Insert tun ip cath perc","description":"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, contrast injection when performed, and radiological supervision and interpretation, percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46258","name":"Remove in/ex hem grp w/fistu","description":"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31573","name":"Largsc w/ther injection","description":"Laryngoscopy, flexible; with therapeutic injection(s) (eg, chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83060","name":"Hgb sulfhemoglobin quan","description":"Hemoglobin; sulfhemoglobin, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92315","name":"C-lens fitg tech aphakia 1","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, 1 eye","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35082","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27079","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58740","name":"Adhesiolysis tube ovary","description":"Lysis of adhesions (salpingolysis, ovariolysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0166","name":"Extrnl counterpulse, per tx","description":"External counterpulsation, per treatment session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25259","name":"Manipulate wrist w/anesthes","description":"Manipulation, wrist, under anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15276","name":"Skin sub graft f/n/hf/g addl","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36906","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99607","name":"Mtms by pharm addl 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"S8460","name":"Camisole post-mast","description":"Camisole, post-mastectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99255","name":"Ip/obs consltj new/est hi 80","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 80 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80418","name":"Pituitary evaluation panel","description":"Combined rapid anterior pituitary evaluation panel this panel must include the following: adrenocorticotropic hormone (acth) (82024 x 4) luteinizing hormone (lh) (83002 x 4) follicle stimulating hormone (fsh) (83001 x 4) prolactin (84146 x 4) human growth hormone (hgh) (83003 x 4) cortisol (82533 x ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41010","name":"Incision of tongue fold","description":"Incision of lingual frenum (frenotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44955","name":"Appendectomy add-on","description":"Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40700","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4267","name":"Male condom","description":"Contraceptive supply, condom, male, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11387.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21705","name":"Revision of neck muscle/rib","description":"Division of scalenus anticus; with resection of cervical rib","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33948","name":"Ecmo/ecls daily mgmt-venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-venous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10140","name":"I&d hmtma seroma/fluid collj","description":"Incision and drainage of hematoma, seroma or fluid collection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"Esrd srv 2-3 vsts p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 2-3 face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69300","name":"Revise external ear","description":"Otoplasty, protruding ear, with or without size reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0252","name":"Pet imaging initial dx","description":"Pet imaging, full and partial-ring pet scanners only, for initial diagnosis of breast cancer and/or surgical planning for breast cancer (e.g., initial staging of axillary lymph nodes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15171","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43108","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation and anastomosis(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3730.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9487","name":"Remote e/m est. pt 15mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35612","name":"Bpg subclavian-subclavian","description":"Bypass graft, with other than vein; subclavian-subclavian","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81233","name":"Btk gene common variants","description":"Btk (brutons tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, c481s, c481r, c481f)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82136","name":"Amino acids quant 2-5","description":"Amino acids, 2 to 5 amino acids, quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49592","name":"Rpr aa hrn 1st < 3 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33677","name":"Cl mult vsd w/rem pul band","description":"Closure of multiple ventricular septal defects; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37210","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53410","name":"Reconstruction of urethra","description":"Urethroplasty, 1-stage reconstruction of male anterior urethra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46937","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0436","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47141","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments ii, iii and iv)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3701","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21146","name":"Rcnstj mdfc lefort i 2 w/grf","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95133","name":"Immntx 4 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 4 stinging insect venoms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80160","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4672","name":"Drainage ext line, dialysis","description":"Drainage extension line, sterile, for dialysis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3806.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23615","name":"Optx prox humrl fx w/int fix","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16020","name":"Dress/debrid p-thick burn s","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43770","name":"Lap place gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device (eg, gastric band and subcutaneous port components)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34841","name":"Endovasc visc aorta 1 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38100","name":"Removal of spleen total","description":"Splenectomy; total (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"37247","name":"Trluml balo angiop addl art","description":"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86325","name":"Other immunoelectrophoresis","description":"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"Esrd svc pr day pt 2-11","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 2-11 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15958","name":"Exc trchntr pr ulc prep ostc","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50060","name":"Nl removal calculus","description":"Nephrolithotomy; removal of calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578T","name":"Rem interrog dev icds phys","description":"Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87631","name":"Resp virus 3-5 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86077","name":"Phys blood bank serv xmatch","description":"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93721","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5942.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82803","name":"Blood gases any combination","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21436","name":"Optx crnfcl sep comp mlt int","description":"Open treatment of craniofacial separation (lefort iii type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80416","name":"Renin stimulation panel","description":"Renal vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 6)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21151","name":"Rcnstj mdfc lefrtii w/b1 grf","description":"Reconstruction midface, lefort ii; any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"29705","name":"Rmvl/bivlv full arm/leg cast","description":"Removal or bivalving; full arm or full leg cast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15131","name":"Drm agrft t/a/l ea addl","description":"Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4732.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15770","name":"Derma-fat-fascia graft","description":"Graft; derma-fat-fascia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6702.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96413","name":"Chemo iv infusion 1 hr","description":"Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33782","name":"Nikaidoh proc","description":"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, nikaidoh procedure); without coronary ostium reimplantation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7043","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7510","name":"Prosthetic device repair rep","description":"Repair of prosthetic device, repair or replace minor parts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27486","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; 1 component","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69637","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34712","name":"Tcat dlvr enhncd fixj dev","description":"Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26341","name":"Manipulat palm cord post inj","description":"Manipulation, palmar fascial cord (ie, dupuytrens cord), post enzyme injection (eg, collagenase), single cord","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95170","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; whole body extract of biting insect or other arthropod (specify number of doses)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44021","name":"Decompress small bowel","description":"Enterotomy, small intestine, other than duodenum; for decompression (eg, baker tube)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47740","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26118","name":"Rad resect hand tumor 3 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of hand or finger; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31572","name":"Largsc w/laser dstrj les","description":"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65756","name":"Corneal trnspl endothelial","description":"Keratoplasty (corneal transplant); endothelial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"49594","name":"Rpr aa hrn 1st 3-10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); 3 cm to 10 cm, incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33675","name":"Close mult vsd","description":"Closure of multiple ventricular septal defects;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61711","name":"Fusion of skull arteries","description":"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61020","name":"Remove brain cavity fluid","description":"Ventricular puncture through previous burr hole, fontanelle, suture, or implanted ventricular catheter/reservoir; without injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93296","name":"Rem interrog evl pm/ids","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4542","name":"Small disposable underpad","description":"Incontinence product, disposable underpad, small size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86280","name":"Hemagglutination inhibition","description":"Hemagglutination inhibition test (hai)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6393.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88368","name":"Insitu hybridization manual","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96522","name":"Refill/maint pump/resvr syst","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278T","name":"Tempr","description":"Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25900","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23515","name":"Optx clavicular fx w/int fix","description":"Open treatment of clavicular fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0397","name":"Alcohol/subs interv >30 min","description":"Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0076","name":"Care manag h vst new pt 20 m","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33141","name":"Heart tmr w/other procedure","description":"Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45119","name":"Remove rectum w/reservoir","description":"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27226","name":"Treat hip wall fracture","description":"Open treatment of posterior or anterior acetabular wall fracture, with internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64615","name":"Chemodenerv musc migraine","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15920","name":"Exc coccygl pr ulc prim sutr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87481","name":"Candida dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3825.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0232T","name":"Njx platelet plasma","description":"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0504T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27087","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35091","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35371","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; common femoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0101T","name":"Esw muscskel sys nos","description":"Extracorporeal shock wave involving musculoskeletal system, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83921","name":"Organic acid single quant","description":"Organic acid, single, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67974","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0219T","name":"Plmt post facet implt cerv","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99308","name":"Sbsq nf care low mdm 20","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34706","name":"Evasc rpr a-biiliac rpt","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64585","name":"Rev/rmv perph nstim eltrd ra","description":"Revision or removal of peripheral neurostimulator electrode array","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24516","name":"Tx humrl shaft fx imed implt","description":"Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92606","name":"Non-speech device service","description":"Therapeutic service(s) for the use of non-speech-generating device, including programming and modification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96405","name":"Chemo intralesional up to 7","description":"Chemotherapy administration; intralesional, up to and including 7 lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0309","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20245","name":"Bone biopsy open deep","description":"Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0408","name":"Inpt/tele follow up 35","description":"Follow-up inpatient consultation, complex, physicians typically spend 35 minutes communicating with the patient via telehealth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87905","name":"Ia nzmtc actv oth/thn virus","description":"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"99155","name":"Mod sed oth phys/qhp <5 yrs","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger th","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33852","name":"Rpr hypopl a-arch wo byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6491.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15958","name":"Exc trchntr pr ulc prep ostc","description":"Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous flap or skin graft closure; with ostectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67108","name":"Repair detached retina","description":"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35221","name":"Rpr bld vsl dir intra-abdl","description":"Repair blood vessel, direct; intra-abdominal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80502","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0248","name":"Demonstrate use home inr mon","description":"Demonstration, prior to initiation of home inr monitoring, for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria, under the direction of a physician; includes: face-to-face demonstration of use and care of the i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15830","name":"Exc excessive skin abdomen","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":914.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94610","name":"Intrapulm surfactant admn","description":"Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3207","name":"Hightop w/ supp/pronator jun","description":"Orthopedic shoe, hightop with supinator or pronator, junior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0014","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; ambulatory detoxification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24115","name":"Exc/crtg b1 cst/tum hum agrf","description":"Excision or curettage of bone cyst or benign tumor, humerus; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85345","name":"Coagulation time lee & white","description":"Coagulation time; lee and white","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37761","name":"Ligate leg veins open","description":"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35533","name":"Art byp grft axill/fem/fem","description":"Bypass graft, with vein; axillary-femoral-femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1331.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96902","name":"Mcrscp xm hair pluck/clipped","description":"Microscopic examination of hairs plucked or clipped by the examiner (excluding hair collected by the patient) to determine telogen and anagen counts, or structural hair shaft abnormality","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0512T","name":"Esw integ wnd hlg 1st wnd","description":"Extracorporeal shock wave for integumentary wound healing, including topical application and dressing care; initial wound","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29822","name":"Sho arthrs srg lmtd dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"Esrd home pt serv p mo 20+","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 20 years of age and older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84207","name":"Assay of vitamin b-6","description":"Pyridoxal phosphate (vitamin b-6)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3076.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50390","name":"Drainage of kidney lesion","description":"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0325","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31600","name":"Planned tracheostomy","description":"Tracheostomy, planned (separate procedure);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97763","name":"Orthc/prostc mgmt sbsq enc","description":"Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49435","name":"Insert subq exten to ip cath","description":"Insertion of subcutaneous extension to intraperitoneal cannula or catheter with remote chest exit site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15110","name":"Epidrm agrft t/a/l 1st 100","description":"Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9486","name":"Remote e/m est. pt 10mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward med","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19286","name":"Perq dev breast add us imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23195","name":"Resection humeral head","description":"Resection, humeral head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60545","name":"Explore adrenal gland","description":"Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83951","name":"Oncoprotein dcp","description":"Oncoprotein; des-gamma-carboxy-prothrombin (dcp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61564","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25426","name":"Repair/graft radius & ulna","description":"Repair of defect with autograft; radius and ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42408","name":"Excision of salivary cyst","description":"Excision of sublingual salivary cyst (ranula)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25445","name":"Arthrp w/prostc trapezium","description":"Arthroplasty with prosthetic replacement; trapezium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89220","name":"Sputum specimen collection","description":"Sputum, obtaining specimen, aerosol induced technique (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26113","name":"Exc hand tum deep 1.5 cm/>","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64681","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15274","name":"Skn sub grft t/a/l child add","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88372","name":"Protein analysis w/probe","description":"Protein analysis of tissue by western blot, with interpretation and report; immunological probe for band identification, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0555","name":"Humidifier for use w/ regula","description":"Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"17284","name":"Dstr mal ls f/e/e/n/l/m3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36620","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0700","name":"Safety equipment","description":"Safety equipment, device or accessory, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84119","name":"Test urine for porphyrins","description":"Porphyrins, urine; qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19535.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99427","name":"Prin care mgmt staff ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69955","name":"Release facial nerve","description":"Total facial nerve decompression and/or repair (may include graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6079.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27257","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S1040","name":"Cranial remolding orthosis","description":"Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3265.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35539","name":"Art byp grft aortofemoral","description":"Bypass graft, with vein; aortofemoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24320","name":"Tenoplasty elbow to sho 1","description":"Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (seddon-brookes type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44372","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2940.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26596","name":"Excision constricting tissue","description":"Excision of constricting ring of finger, with multiple z-plasties","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4725.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0144","name":"Azithromycin dihydrate, oral","description":"Azithromycin dihydrate, oral, capsules/powder, 1 gram","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48105","name":"Resect/debride pancreas","description":"Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5330.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36511","name":"Apheresis wbc","description":"Therapeutic apheresis; for white blood cells","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93298","name":"Rem interrog dev eval scrms","description":"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68340","name":"Separate eyelid adhesions","description":"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67975","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61526","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2950.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28102","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96413","name":"Chemo iv infusion 1 hr","description":"Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24155","name":"Resection of elbow joint","description":"Resection of elbow joint (arthrectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76880","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0111","name":"Wet mounts/ w preparations","description":"Wet mounts, including preparations of vaginal, cervical or skin specimens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41135","name":"Tongue and neck surgery","description":"Glossectomy; partial, with unilateral radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47001","name":"Ndl biopsy lvr tm oth maj px","description":"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6716.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21121","name":"Geniop sldg osteot 1","description":"Genioplasty; sliding osteotomy, single piece","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85302","name":"Clot inhibit prot c antigen","description":"Clotting inhibitors or anticoagulants; protein c, antigen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0241","name":"Bath tub wall rail","description":"Bath tub wall rail, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49452","name":"Replace g-j tube perc","description":"Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27087","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32800","name":"Repair lung hernia","description":"Repair lung hernia through chest wall","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9481","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history;  a problem focused examination; and straightforward medical decision making, furn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2881.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4083","name":"Enteral stomach tube levine","description":"Stomach tube - levine type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45171","name":"Exc rect tum transanal part","description":"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93527","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28531","name":"Treat sesamoid bone fracture","description":"Open treatment of sesamoid fracture, with or without internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69641","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50220","name":"Remove kidney open","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30110","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22862","name":"Rev rplcm rthrp 1ntrspc lmbr","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2116.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3254","name":"Orth foot non-stndard size/w","description":"Non-standard size or width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88248","name":"Chromosome analysis 50-100","description":"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, fanconi anemia, fragile x)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87850","name":"N. gonorrhoeae assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; neisseria gonorrhoeae","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84449","name":"Assay of transcortin","description":"Transcortin (cortisol binding globulin)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49084","name":"Peritoneal lavage","description":"Peritoneal lavage, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46080","name":"Sphnctrotmy anal div sphnctr","description":"Sphincterotomy, anal, division of sphincter (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4913.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0209T","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold), automated; air and bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33254","name":"Ablate atria lmtd","description":"Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25075","name":"Exc forearm les sc < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0145","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24201","name":"Rmvl fb upper arm/elbw deep","description":"Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96523","name":"Irrig drug delivery device","description":"Irrigation of implanted venous access device for drug delivery systems","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86816","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, single antigen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3395.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27472","name":"Repair/graft of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26916.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90819","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26705","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43261","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25515","name":"Optx radial shaft fracture","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45383","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67966","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58200","name":"Extensive hysterectomy","description":"Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87390","name":"Hiv-1 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31552","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25446","name":"Arthrp w/prostc dst rds&crps","description":"Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0484T","name":"Tmvi transthoracic exposure","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44955","name":"Appendectomy add-on","description":"Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43333","name":"Transab esoph hiat hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3204","name":"Hightop w/ supp/pronator inf","description":"Orthopedic shoe, hightop with supinator or pronator, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27810","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9488","name":"Remote e/m est. pt 25mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of modera","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1529.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15828","name":"Rhytidectomy cheek chn & nck","description":"Rhytidectomy; cheek, chin, and neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96365","name":"Ther/proph/diag iv inf init","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49505","name":"Prp i/hern init reduc >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; reducible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64480","name":"Njx aa&/strd tfrm epi c/t ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44144","name":"Partial removal of colon","description":"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"89220","name":"Sputum specimen collection","description":"Sputum, obtaining specimen, aerosol induced technique (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57061","name":"Destruction vag lesions smpl","description":"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64622","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57531","name":"Removal of cervix radical","description":"Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21244","name":"Reconstruction of lower jaw","description":"Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64476","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92202","name":"Opscpy extnd on/mac draw","description":"Ophthalmoscopy, extended; with drawing of optic nerve or macula (eg, for glaucoma, macular pathology, tumor) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86705","name":"Hep b core antibody igm","description":"Hepatitis b core antibody (hbcab); igm antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0031A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33971","name":"Aortic circulation assist","description":"Removal of intra-aortic balloon assist device including repair of femoral artery, with or without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34846","name":"Visc & infraren abd 2 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32098","name":"Open biopsy of lung pleura","description":"Thoracotomy, with biopsy(ies) of pleura","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35266","name":"Rpr blvsl grf oth/th vn uxtr","description":"Repair blood vessel with graft other than vein; upper extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95977","name":"Alys cplx cn npgt prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49505","name":"Prp i/hern init reduc >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19368","name":"Brst rcnstj 1pdcl tram anast","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap, requiring separate microvascular anastomosis (supercharging)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99380","name":"Nursing fac care supervision","description":"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, comm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2248.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4290","name":"Sacral nerve stim test lead","description":"Sacral nerve stimulation test lead, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87143","name":"Culture typing glc/hplc","description":"Culture, typing; gas liquid chromatography (glc) or high pressure liquid chromatography (hplc) method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15783","name":"Dermabrasion suprfl any site","description":"Dermabrasion; superficial, any site (eg, tattoo removal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43234","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99448","name":"Ntrprof ph1/ntrnet/ehr 21-30","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15130","name":"Drm agrft t/a/l 1st 100 sqcm","description":"Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95984","name":"Alys brn npgt prgrmg addl 15","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36254","name":"Ins cath ren art 2nd+ bilat","description":"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, an","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41155","name":"Tongue jaw & neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (commando type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67039","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0102","name":"Prostate ca screening; dre","description":"Prostate cancer screening; digital rectal examination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17855.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22103","name":"Remove extra spine segment","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99334","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58260","name":"Vaginal hysterectomy","description":"Vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46275","name":"Remove anal fist inter","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7274","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14302","name":"Tis trnfr addl 30 sq cm","description":"Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32669","name":"Thoracoscopy remove segment","description":"Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46917","name":"Laser surgery anal lesions","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64861","name":"Repair of arm nerves","description":"Suture of; brachial plexus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51980","name":"Construct bladder opening","description":"Cutaneous vesicostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99285","name":"Emergency dept visit hi mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4552.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11424","name":"Exc h-f-nk-sp b9+marg 3.1-4","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88318","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42106","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with simple primary closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35305","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35473","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33954","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, 6 years and older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55840","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62000","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; simple, extradural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3700","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2204.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11005","name":"Dbrdmt skin abdominal wall","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25316","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist; with tendon(s) transfer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80195","name":"Assay of sirolimus","description":"Sirolimus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78268","name":"Urea breath test c-14 alys","description":"Urea breath test, c-14 (isotopic); analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35511","name":"Art byp grft subclav-subclav","description":"Bypass graft, with vein; subclavian-subclavian","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46700","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; adult","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21462","name":"Optx mndblr fx w/ntrdntl","description":"Open treatment of mandibular fracture; with interdental fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91065","name":"Breath hydrogen/methane test","description":"Breath hydrogen or methane test (eg, for detection of lactase deficiency, fructose intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93583","name":"Perq transcath septal reduxn","description":"Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43276","name":"Ercp stent exchange w/dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"T5001","name":"Position seat spec orth need","description":"Positioning seat for persons with special orthopedic needs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11402","name":"Exc tr-ext b9+marg 1.1-2 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28981.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27194","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92140","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90810","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69740","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50540","name":"Revision of horseshoe kidney","description":"Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93563","name":"Njx cgen car cth slctv c ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65860","name":"Severing ads ant sgm laser","description":"Severing adhesions of anterior segment, laser technique (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65775","name":"Correction of astigmatism","description":"Corneal wedge resection for correction of surgically induced astigmatism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2559.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81189","name":"Cstb gene full gene sequence","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; full gene sequence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80432","name":"Insulin suppression panel","description":"Insulin-induced c-peptide suppression panel this panel must include the following: insulin (83525) c-peptide (84681 x 5) glucose (82947 x 5)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84152","name":"Assay of psa complexed","description":"Prostate specific antigen (psa); complexed (direct measurement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3790.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49906","name":"Free omental flap microvasc","description":"Free omental flap with microvascular anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99409","name":"Audit/dast over 30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; greater than 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86828","name":"Hla class i&ii antibody qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to hla class i and class ii hla antigens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93017","name":"Cv stress test tracing only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87040","name":"Blood culture for bacteria","description":"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15366","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33259","name":"Ablate atria w/bypass add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24164","name":"Removal prosth radial head","description":"Removal of prosthesis, includes debridement and synovectomy when performed; radial head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"P2038","name":"Blood mucoprotein","description":"Mucoprotein, blood (seromucoid) (medical necessity procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51535","name":"Repair of ureter lesion","description":"Cystotomy for excision, incision, or repair of ureterocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36475","name":"Endovenous rf 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37192","name":"Redo endovas vena cava filtr","description":"Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30468","name":"Rpr nsl vlv collapse w/implt","description":"Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35251","name":"Rpr blvsl vn grf intra-abdl","description":"Repair blood vessel with vein graft; intra-abdominal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45135","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61526","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80050","name":"General health panel","description":"General health panel this panel must include the following: comprehensive metabolic panel (80053) blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15657.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64902","name":"Nerve graft add-on","description":"Nerve graft, each additional nerve; multiple strands (cable) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4261","name":"Cervical cap contraceptive","description":"Cervical cap for contraceptive use","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44143","name":"Partial removal of colon","description":"Colectomy, partial; with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93016","name":"Cv stress test supvj only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52343","name":"Cysto w/renal stricture tx","description":"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92602","name":"Reprogram cochlear implt <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44394","name":"Colonoscopy w/snare","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31629","name":"Bronchoscopy/needle bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36475","name":"Endovenous rf 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, radiofrequency; first vein treated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58542","name":"Lsh w/t/o ut 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21742","name":"Repair stern/nuss w/o scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), without thoracoscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33762","name":"Shunt desc aorta to pulm art","description":"Shunt; descending aorta to pulmonary artery (potts-smith type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3213","name":"Benesch boot pair child","description":"Benesch boot, pair, child","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3700","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19355","name":"Correct inverted nipple(s)","description":"Correction of inverted nipples","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21154","name":"Rcnstj mdfc lefort iii w/o i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33410","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31081","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59120","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82542","name":"Col chromotography qual/quan","description":"Column chromatography, includes mass spectrometry, if performed (eg, hplc, lc, lc/ms, lc/ms-ms, gc, gc/ms-ms, gc/ms, hplc/ms), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31395","name":"Reconstruct larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; with reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31654","name":"Bronch ebus ivntj perph les","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transendoscopic endobronchial ultrasound (ebus) during bronchoscopic diagnostic or therapeutic intervention(s) for peripheral lesion(s) (list separately in addition to code for primary procedure[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26645","name":"Treat thumb fracture","description":"Closed treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28575","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26478","name":"Lengthening of hand tendon","description":"Lengthening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33258","name":"Ablate atria x10sv add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85293","name":"Clot factor wght kininogen","description":"Clotting; high molecular weight kininogen assay (fitzgerald factor assay)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43855","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43320","name":"Fuse esophagus & stomach","description":"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21083","name":"Impres&prep paltl lft prosth","description":"Impression and custom preparation; palatal lift prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43641","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87515","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6013","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3112.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97761","name":"Prosthetic traing 1st enc","description":"Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26776","name":"Pin finger dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87280","name":"Respiratory syncytial ag if","description":"Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1299.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83913","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96167","name":"Hlth bhv ivntj fam 1st 30","description":"Health behavior intervention, family (with the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1255.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35583","name":"Vein byp grft fem-popliteal","description":"In-situ vein bypass; femoral-popliteal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4527","name":"Adult size pull-on lg","description":"Adult sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77423","name":"Neutron beam tx complex","description":"High energy neutron radiation treatment delivery, 1 or more isocenter(s) with coplanar or non-coplanar geometry with blocking and/or wedge, and/or compensator(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43648","name":"Lap revise/remv eltrd antrum","description":"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4750","name":"Art or venous blood tubing","description":"Blood tubing, arterial or venous, for hemodialysis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55870","name":"Electroejaculation","description":"Electroejaculation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50947","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26373","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; secondary without free graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20983","name":"Ablate bone tumor(s) perq","description":"Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; cryoablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4621.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4247","name":"Betadine/iodine swabs/wipes","description":"Betadine or iodine swabs/wipes, per box","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21013","name":"Exc face tum deep < 2 cm","description":"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22551","name":"Arthrd ant ntrbdy cervical","description":"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below c2","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11424","name":"Exc h-f-nk-sp b9+marg 3.1-4","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"U0004","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67335","name":"Eye suture during surgery","description":"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (list separately in addition to code for specific strabismus surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87633","name":"Resp virus 12-25 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0108","name":"W/c component-accessory nos","description":"Wheelchair component or accessory, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01926","name":"Anes ivntl rad icr icar/aort","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9141","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0149T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33608","name":"Repair anomaly w/conduit","description":"Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0372","name":"Md service required for pmd","description":"Physician service required to establish and document the need for a power mobility device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27497","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94781","name":"Cars/bd tst inft-12mo +30min","description":"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; each additional full 30 minutes (list separately in addition to code","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97036","name":"App mdlty 1+hubbrd tnk ea 15","description":"Application of a modality to 1 or more areas; hubbard tank, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6213","name":"Foam drg >16<=48 sq in w/bdr","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27620","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53060","name":"Drainage of urethra abscess","description":"Drainage of skenes gland abscess or cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85175","name":"Blood clot lysis time","description":"Clot lysis time, whole blood dilution","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27824","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93355","name":"Echo transesophageal (tee)","description":"Echocardiography, transesophageal (tee) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, tavr, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63180","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L6639","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54326","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32609","name":"Thoracoscopy w/bx pleura","description":"Thoracoscopy; with biopsy(ies) of pleura","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6250","name":"Skin seal protect moisturizr","description":"Skin sealants, protectants, moisturizers, ointments, any type, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11743.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27690","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0318","name":"Prolong home eval add 15m","description":"Prolonged home or residence evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40019.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63047","name":"Lam facetec & foramot lumbar","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85415","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen activator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49906","name":"Free omental flap microvasc","description":"Free omental flap with microvascular anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44369","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61870","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86744","name":"Nocardia antibody","description":"Antibody; nocardia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50080","name":"Perq nl/pl lithotrp smpl<2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; simple (eg, stone[s] up to 2 cm in single location of kidney or renal pelvis, nonbranching ston","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24579","name":"Optx humrl cndylr fracture","description":"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95145","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); single stinging insect venom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36600","name":"Withdrawal of arterial blood","description":"Arterial puncture, withdrawal of blood for diagnosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52342","name":"Cysto w/up stricture tx","description":"Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"90812","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23450","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; putti-platt procedure or magnuson type operation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9979","name":"Remote e/m new pt 20mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history;  an expanded problem focused e","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35645","name":"Bpg subclavian-vertebral","description":"Bypass graft, with other than vein; subclavian-vertebral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80050","name":"General health panel","description":"General health panel this panel must include the following: comprehensive metabolic panel (80053) blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["11004","11005","11101","11102","11103","11104","11105","11106","11109","11120","11351","11352","11354","11355","11356","11357","11358","11359","11360","11361","11362","11363","11364","11365","11366","11367","11368","11369","11370","11371","11372","11373","11374","11375","11377","11378","11379","11380","11381","11385","11386","11390","11405","11411","11412","11413","11414","11415","11416","11417","11418","11419","11420","11421","11422","11423","11424","11425","11426","11427","11428","11429","11430","11431","11432","11433","11434","11435","11436","11437","11439","11451","11499","11690","11691","11692","11693","11694","11695","11697"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96375","name":"Tx/pro/dx inj new drug addon","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87653","name":"Strep b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group b, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90951","name":"Esrd serv 4 visits p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care pro","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77031","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85380","name":"Fibrin degradj d-dimer","description":"Fibrin degradation products, d-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87327","name":"Cryptococcus neoform ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptococcus neoformans","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2064","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32507","name":"Wedge resect of lung diag","description":"Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26358","name":"Repair/graft hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0238","name":"Oth resp proc, indiv","description":"Therapeutic procedures to improve respiratory function, other than described by g0237, one on one, face to face, per 15 minutes (includes monitoring)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61585","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2962.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27111","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to femoral neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4158","name":"Ef ped complete intact nut","description":"Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92072","name":"Fitg c-lens keratoconus 1st","description":"Fitting of contact lens for management of keratoconus, initial fitting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15771.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4180","name":"Parenteral sol carb > 50%","description":"Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87800","name":"Detect agnt mult dna direc","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; direct probe(s) technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2212","name":"Prolong outpt/office vis","description":"Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or w","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85420","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7929.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64447","name":"Njx aa&/strd femoral nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27066","name":"Remove hip bone les deep","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77401","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61521","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2002","name":"Post-d/c h vst new pt 30 m","description":"Limited (30 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27538","name":"Treat knee fracture(s)","description":"Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35626","name":"Bpg aor-subcla/innom/carotid","description":"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33229","name":"Remv&replc pm gen mult leads","description":"Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator; multiple lead system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62263","name":"Epidural lysis mult sessions","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32670","name":"Thoracoscopy bilobectomy","description":"Thoracoscopy, surgical; with removal of two lobes (bilobectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27075","name":"Resect hip tumor","description":"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1778.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65130","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after evisceration, in scleral shell","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97002","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35634","name":"Bpg iliorenal","description":"Bypass graft, with other than vein; iliorenal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0413","name":"Pelvic ring fracture uni/bil","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52649","name":"Prostate laser enucleation","description":"Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61619","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis muscle)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91303","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33406","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49411","name":"Ins mark abd/pel for rt perq","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-abdominal, intra-pelvic (except prostate), and/or retroperitoneum, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21159","name":"Rcnst mdfc lfrtiii advm wo i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2119.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26356","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); primary, without free graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15040","name":"Harvest cultured skin graft","description":"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93750","name":"Interrogation vad in person","description":"Interrogation of ventricular assist device (vad), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming, if performe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37235","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63081","name":"Remove vert body dcmprn crvl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14418.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64590","name":"Ins/rpl prph sac/gstr npg/r","description":"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51798","name":"Us urine capacity measure","description":"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28455","name":"Tx tarsal b1 fx w/mnpj each","description":"Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36640","name":"Insertion catheter artery","description":"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32141","name":"Remove/treat lung lesions","description":"Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27372","name":"Removal of foreign body","description":"Removal of foreign body, deep, thigh region or knee area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51100","name":"Drain bladder by needle","description":"Aspiration of bladder; by needle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54500","name":"Biopsy of testis","description":"Biopsy of testis, needle (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4565.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35761","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32998","name":"Ablate pulm tumor perq rf","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; radiofrequency","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2604.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6250","name":"Skin seal protect moisturizr","description":"Skin sealants, protectants, moisturizers, ointments, any type, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86651","name":"Encephalitis californ antbdy","description":"Antibody; encephalitis, california (la crosse)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84206","name":"Assay of proinsulin","description":"Proinsulin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88261","name":"Chromosome analysis 5","description":"Chromosome analysis; count 5 cells, 1 karyotype, with banding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15278","name":"Skn sub grft f/n/hf/g ch add","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6215","name":"Foam dressing wound filler","description":"Foam dressing, wound filler, sterile, per gram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62163","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9987","name":"Bpci advanced in home visit","description":"Bundled payments for care improvement advanced (bpci advanced) model home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/am","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4001.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19101","name":"Biopsy of breast open","description":"Biopsy of breast; open, incisional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11103","name":"Tangntl bx skin ea sep/addl","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93702","name":"Bis xtracell fluid analysis","description":"Bioimpedance spectroscopy (bis), extracellular fluid analysis for lymphedema assessment(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2325.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9868","name":"Cmmi asyntelehealth <10min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, less than 10 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4102","name":"Ef adult fluids and electro","description":"Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27760","name":"Cltx medial ankle fx","description":"Closed treatment of medial malleolus fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39560","name":"Resect diaphragm simple","description":"Resection, diaphragm; with simple repair (eg, primary suture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44139","name":"Mobilization of colon","description":"Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7239.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97610","name":"Low frequency non-thermal us","description":"Low frequency, non-contact, non-thermal ultrasound, including topical application(s), when performed, wound assessment, and instruction(s) for ongoing care, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G3002","name":"Chronic pain mgmt 30 mins","description":"Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan that includes strengths, goals, clinical needs,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37618","name":"Ligation major artery xtr","description":"Ligation, major artery (eg, post-traumatic, rupture); extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57112","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26040","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50576","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2150.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93514","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25332","name":"Revise wrist joint","description":"Arthroplasty, wrist, with or without interposition, with or without external or internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23466","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65103","name":"Remove eye/insert implant","description":"Enucleation of eye; with implant, muscles not attached to implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83907","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0429","name":"Dermal filler injection(s)","description":"Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23650","name":"Cltx sho dslc w/mnpj wo anes","description":"Closed treatment of shoulder dislocation, with manipulation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99354","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35570","name":"Art byp tibial-tib/peroneal","description":"Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99439","name":"Chrnc care mgmt staf ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6239","name":"Hydrocolld drg > 48 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81182","name":"Atxn8os gen detc abnor allel","description":"Atxn8os (atxn8 opposite strand [non-protein coding]) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"20225","name":"Bone biopsy trocar/ndl deep","description":"Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51102","name":"Drain bl w/cath insertion","description":"Aspiration of bladder; with insertion of suprapubic catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64840","name":"Repair of leg nerve","description":"Suture of posterior tibial nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26862","name":"Fusion/graft of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87116","name":"Mycobacteria culture","description":"Culture, tubercle or other acid-fast bacilli (eg, tb, afb, mycobacteria) any source, with isolation and presumptive identification of isolates","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90461","name":"Im admin each addl component","description":"Immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; each additional vaccine or toxoid component administered (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11008","name":"Rmv prstc mtrl/mesh abd wall","description":"Removal of prosthetic material or mesh, abdominal wall for infection (eg, for chronic or recurrent mesh infection or necrotizing soft tissue infection) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64856","name":"Repair/transpose nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"57111","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29855","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87500","name":"Vanomycin dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); vancomycin resistance (eg, enterococcus species van a, van b), amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44393","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33788","name":"Revision of pulmonary artery","description":"Reimplantation of an anomalous pulmonary artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58976","name":"Transfer of embryo","description":"Gamete, zygote, or embryo intrafallopian transfer, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86832","name":"Hla class i high defin qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), hla class i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6206","name":"Contact layer <= 16 sq in","description":"Contact layer, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95978","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4671","name":"Disposable cycler set","description":"Disposable cycler set used with cycler dialysis machine, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25028","name":"I&d f/arm&/wrst dp absc/hmtm","description":"Incision and drainage, forearm and/or wrist; deep abscess or hematoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75940","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93228","name":"Remote 30 day ecg rev/report","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27187","name":"Reinforce hip bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP06","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11901","name":"Inject skin lesions >7","description":"Injection, intralesional; more than 7 lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46262","name":"Remove in/ex hem grps w/fist","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96139","name":"Psycl/nrpsyc tst tech ea","description":"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82085","name":"Assay of aldolase","description":"Aldolase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43330","name":"Esophagomyotomy abdominal","description":"Esophagomyotomy (heller type); abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99464","name":"Attendance at delivery","description":"Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22116","name":"Remove extra spine segment","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87492","name":"Chlmyd trach dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29855","name":"Tibial arthroscopy/surgery","description":"Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99185","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48150","name":"Partial removal of pancreas","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31545","name":"Remove vc lesion w/scope","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63082","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64832","name":"Repair nerve add-on","description":"Suture of digital nerve, hand or foot; each additional digital nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53620","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; initial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29873","name":"Arthrs knee surg w/lat rls","description":"Arthroscopy, knee, surgical; with lateral release","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9488","name":"Remote e/m est. pt 25mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of modera","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32422","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72159","name":"Mr angio spine w/o&w/dye","description":"Magnetic resonance angiography, spinal canal and contents, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33956","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44384","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40819","name":"Excise lip or cheek fold","description":"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2528.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99337","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19301","name":"Partial mastectomy","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44010","name":"Incision of small bowel","description":"Duodenotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30000","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal, internal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69601","name":"Revj mstdc rsltg compl mstdc","description":"Revision mastoidectomy; resulting in complete mastoidectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0480","name":"Drug test def 1-7 classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22840","name":"Insert spine fixation device","description":"Posterior non-segmental instrumentation (eg, harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at c1, facet screw fixation) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61640","name":"Dilate ic vasospasm init","description":"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26412","name":"Repair/graft hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27025","name":"Fasciotomy hip/thigh any typ","description":"Fasciotomy, hip or thigh, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33692","name":"Comp rpr tof wo pulm atresia","description":"Complete repair tetralogy of fallot without pulmonary atresia;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50323","name":"Prep cadaver renal allograft","description":"Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1578.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0080","name":"Care manag h vst new pt 75 m","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65286","name":"Repair of eye wound","description":"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41827","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82306","name":"Vitamin d 25 hydroxy","description":"Vitamin d; 25 hydroxy, includes fraction(s), if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505T","name":"Ev fempop artl revsc","description":"Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapp","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58150","name":"Total hysterectomy","description":"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12034","name":"Intmd rpr s/tr/ext 7.6-12.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90813","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8189","name":"Trach supply noc","description":"Tracheostomy supply, not otherwise classified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37607","name":"Lig/banding angioacs av fstl","description":"Ligation or banding of angioaccess arteriovenous fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95980","name":"Io anal gast n-stim init","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67904","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67912","name":"Correction eyelid w/implant","description":"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33853","name":"Rpr hypopl a-arch w/byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0311","name":"Immunize counsel 16-30 mins","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service,  16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83018","name":"Heavy metal quan each nes","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); quantitative, each, not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64553","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; cranial nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4349.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4932","name":"Reusable rectal thermometer","description":"Rectal thermometer, reusable, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6967.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88167","name":"Cytopath tbs c/v select","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43760","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52344","name":"Cysto/uretero stricture tx","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93294","name":"Rem interrog evl pm/ldls pm","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81165","name":"Brca1 gene full seq alys","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99215","name":"Office o/p est hi 40 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28615","name":"Repair foot dislocation","description":"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50300","name":"Remove cadaver donor kidney","description":"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92317","name":"C-lens fitg tech corneosclrl","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneoscleral lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64435","name":"Njx aa&/strd paracrv nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4798.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49492","name":"Rpr ing hern premie blocked","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27596","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; re-amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20936","name":"Sp bone agrft local add-on","description":"Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23145","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0454","name":"Md document visit by npp","description":"Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50972","name":"Ureter endoscopy & catheter","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44379","name":"S bowel endoscope w/stent","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44139","name":"Mobilization of colon","description":"Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42104","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; without closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27514","name":"Treatment of thigh fracture","description":"Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27122","name":"Reconstruction of hip socket","description":"Acetabuloplasty; resection, femoral head (eg, girdlestone procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26200","name":"Remove hand bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G6019","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80158","name":"Drug assay cyclosporine","description":"Cyclosporine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7534.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3899.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65135","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35656","name":"Bpg femoral-popliteal","description":"Bypass graft, with other than vein; femoral-popliteal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33517","name":"Cabg artery-vein single","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein graft (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33917","name":"Repair pulmonary artery","description":"Repair of pulmonary artery stenosis by reconstruction with patch or graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5311","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35454","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35549","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2142.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29806","name":"Sho arthrs srg capsulorraphy","description":"Arthroscopy, shoulder, surgical; capsulorrhaphy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98966","name":"Ph1 assmt&mgmt nqhp 5-10","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4775.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57210","name":"Repair vagina/perineum","description":"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"12042","name":"Intmd rpr n-hf/genit2.6-7.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29835","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97162","name":"Pt eval mod complex 30 min","description":"Physical therapy evaluation: moderate complexity, requiring these components: a history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures in addressing a total of 3 or more elements fro","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33225","name":"L ventric pacing lead add-on","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP23","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33536","name":"Cabg arterial four or more","description":"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87153","name":"Dna/rna sequencing","description":"Culture, typing; identification by nucleic acid sequencing method, each isolate (eg, sequencing of the 16s rrna gene)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17262","name":"Dstrj mal les t/a/l 1.1-2.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15155","name":"Tis cltr agrft f/s/n/h/f/g 1","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35558","name":"Art byp grft fem-femoral","description":"Bypass graft, with vein; femoral-femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38550","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10009","name":"Fna bx w/ct gdn 1st les","description":"Fine needle aspiration biopsy, including ct guidance; first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45338","name":"Sigmoidoscopy w/tumr remove","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54326","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47550","name":"Bile duct endoscopy add-on","description":"Biliary endoscopy, intraoperative (choledochoscopy) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44156","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with continent ileostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95724","name":"Eeg phy/qhp>60<84 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of eeg recording, with video (veeg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4252","name":"Blood ketone test or strip","description":"Blood ketone test or reagent strip, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58974","name":"Embryo transfer intrauterine","description":"Embryo transfer, intrauterine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33289","name":"Tcat impl wrls p-art prs snr","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization, radiological supervision and interpretation, and pulmonary artery angiog","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19370","name":"Revj peri-implt capsule brst","description":"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15040","name":"Harvest cultured skin graft","description":"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2292","name":"Planar seat for ped size wc","description":"Seat, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20600","name":"Drain/inj joint/bursa w/o us","description":"Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64647","name":"Chemodenerv trunk musc 6/>","description":"Chemodenervation of trunk muscle(s); 6 or more muscles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56440","name":"Mrsplzatn brthlns glnd cst","description":"Marsupialization of bartholins gland cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20560","name":"Ndl insj w/o njx 1 or 2 musc","description":"Needle insertion(s) without injection(s); 1 or 2 muscle(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93555","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21339","name":"Open nasoethmoid fx w/ fixj","description":"Open treatment of nasoethmoid fracture; with external fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88371","name":"Protein western blot tissue","description":"Protein analysis of tissue by western blot, with interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26392","name":"Repair/graft hand tendon","description":"Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89049","name":"Chct for mal hyperthermia","description":"Caffeine halothane contracture test (chct) for malignant hyperthermia susceptibility, including interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28606","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0500","name":"Mod sedat endo service >5yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousness ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22870","name":"Insj stablj dev w/o dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99486","name":"Suprv interfac trnsport addl","description":"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data inter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38700","name":"Removal of lymph nodes neck","description":"Suprahyoid lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["AW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4034","name":"Enter feed supkit syr by day","description":"Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45172","name":"Exc rect tum transanal full","description":"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33362","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open femoral artery approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99143","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50390","name":"Drainage of kidney lesion","description":"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23125","name":"Claviculectomy total","description":"Claviculectomy; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97532","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27625","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33959","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0342","name":"Laparoscopy islet cell trans","description":"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27049","name":"Resect hip/pelv tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of pelvis and hip area; less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64610","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26100","name":"Biopsy hand joint lining","description":"Arthrotomy with biopsy; carpometacarpal joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67904","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92227","name":"Img rta detcj/mntr ds staff","description":"Imaging of retina for detection or monitoring of disease; with remote clinical staff review and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35537","name":"Art byp grft aortoiliac","description":"Bypass graft, with vein; aortoiliac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43763","name":"Rplc gtube revj gstrst trc","description":"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36571","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37785","name":"Ligate/divide/excise vein","description":"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31582","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86920","name":"Compatibility test spin","description":"Compatibility test each unit; immediate spin technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25400","name":"Repair radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; without graft (eg, compression technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84235","name":"Assay of endocrine hormone","description":"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78473","name":"Gated heart multiple","description":"Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion study plus ejection fraction, at rest and stress (exercise and/or pharmacologic), with or without additional quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15005","name":"Wnd prep f/n/hf/g addl cm","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93875","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46948","name":"Int hrhc tranal dartlzj 2+","description":"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57170","name":"Fitting of diaphragm/cap","description":"Diaphragm or cervical cap fitting with instructions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15620","name":"Delay flap f/c/c/n/ax/g/h/f","description":"Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87186","name":"Sc std microdil/agar dil","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [mic] or breakpoint), each multi-antimicrobial, per plate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29584","name":"Appl mltlay cmprn sys up arm","description":"Application of multi-layer compression system; upper arm, forearm, hand, and fingers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15832","name":"Exc excessive skin thigh","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51728","name":"Cystometrogram w/vp","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2355.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86408","name":"Neutrlzg antb sarscov2 scr","description":"Neutralizing antibody, severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]); screen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65760","name":"Keratomileusis","description":"Keratomileusis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4931","name":"Reusable oral thermometer","description":"Oral thermometer, reusable, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31633","name":"Bronchoscopy/needle bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2508.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21268","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31641","name":"Bronchoscopy treat blockage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (eg, laser therapy, cryotherapy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35526","name":"Art byp grft aor/carot/innom","description":"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61867","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of intraoperative microelectrode recording; first array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2092.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62318","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37249","name":"Trluml balo angiop addl vein","description":"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64595","name":"Rev/rmv prph sac/gstr npg/r","description":"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1725","name":"Cath, translumin non-laser","description":"Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81518","name":"Onc brst mrna 11 genes","description":"Oncology (breast), mrna, gene expression profiling by real-time rt-pcr of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage risk for metastatic recurrence and likelihood of benefit from extended endocrine therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3475.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93242","name":"Ext ecg>48hr<7d recording","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; recording (includes connection and initial recording)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","AU","AV","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28737","name":"Revision of foot bones","description":"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99409","name":"Audit/dast over 30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; greater than 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27066","name":"Remove hip bone les deep","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; deep (subfascial), includes autograft, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1166.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44100","name":"Biopsy of bowel","description":"Biopsy of intestine by capsule, tube, peroral (1 or more specimens)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77411","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87653","name":"Strep b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group b, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78351","name":"Bone mineral dual photon","description":"Bone density (bone mineral content) study, 1 or more sites; dual photon absorptiometry, 1 or more sites","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33776","name":"Rpr tga atr bfl clsr vsd","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass; with closure of ventricular septal defect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69676","name":"Remove middle ear nerve","description":"Tympanic neurectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0340","name":"Robt lin-radsurg fractx 2-5","description":"Image-guided robotic linear accelerator-based stereotactic radiosurgery, delivery including collimator changes and custom plugging, fractionated treatment, all lesions, per session, second through fifth sessions, maximum five sessions per course of treatment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21554","name":"Exc neck tum deep 5 cm/>","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96370","name":"Sc ther infusion addl hr","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27601","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1619.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63198","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29866","name":"Autgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograft[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43361","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4150","name":"Ef complet w/intact nutrient","description":"Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15953","name":"Exc trchntr pr ulc flp ostc","description":"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0518T","name":"Rmvl pg wcs lv battery only","description":"Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; battery component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95165","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33413","name":"Replacement of aortic valve","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (ross procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2813.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87641","name":"Mr-staph dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); staphylococcus aureus, methicillin resistant, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11010","name":"Debride skin at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5105.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61798","name":"Srs cranial lesion complex","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88740","name":"Transcutaneous carboxyhb","description":"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13150","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67229","name":"Tr retinal les preterm inf","description":"Treatment of extensive or progressive retinopathy, 1 or more sessions, preterm infant (less than 37 weeks gestation at birth), performed from birth up to 1 year of age (eg, retinopathy of prematurity), photocoagulation or cryotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15620","name":"Delay flap f/c/c/n/ax/g/h/f","description":"Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20933","name":"Hemicrt intrclry algrft prtl","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99192","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47505","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57556","name":"Remove cervix repair bowel","description":"Excision of cervical stump, vaginal approach; with repair of enterocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63102","name":"Remove vert body dcmprn lmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95017","name":"All tstg perq&iq w/venoms","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with venoms, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3223.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69715","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49568","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36253","name":"Ins cath ren art 2nd+ unilat","description":"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, an","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26727","name":"Treat finger fracture each","description":"Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4520","name":"Incontinence garment anytype","description":"Incontinence garment, any type, (e.g., brief, diaper), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16384.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2411.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87285","name":"Treponema pallidum ag if","description":"Infectious agent antigen detection by immunofluorescent technique; treponema pallidum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50561","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84578","name":"Test urine urobilinogen","description":"Urobilinogen, urine; qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64790","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; major peripheral nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11643","name":"Exc f/e/e/n/l mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21208","name":"Augmentation of facial bones","description":"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P7001","name":"Culture bacterial urine","description":"Culture, bacterial, urine; quantitative, sensitivity study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61543","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11743.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95725","name":"Eeg phy/qhp>84 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of eeg recording, without video","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33476","name":"Revision of heart chamber","description":"Right ventricular resection for infundibular stenosis, with or without commissurotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56820","name":"Colposcopy vulva","description":"Colposcopy of the vulva;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61800","name":"Apply srs headframe add-on","description":"Application of stereotactic headframe for stereotactic radiosurgery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63278","name":"Bx/exc xdrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11302","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20561","name":"Ndl insj w/o njx 3+ musc","description":"Needle insertion(s) without injection(s); 3 or more muscles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62329","name":"Ther spi pnxr csf fluor/ct","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or ct guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50395","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61490","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86663","name":"Epstein-barr antibody","description":"Antibody; epstein-barr (eb) virus, early antigen (ea)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20692","name":"Appl mltpln uni ext fixj sys","description":"Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, ilizarov, monticelli type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28250","name":"Revision of foot fascia","description":"Division of plantar fascia and muscle (eg, steindler stripping) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0468T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21616","name":"Exc 1st&/crv rib w/sympth","description":"Excision first and/or cervical rib; with sympathectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82390","name":"Assay of ceruloplasmin","description":"Ceruloplasmin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7523.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61626","name":"Tcat perm occls/embol noncns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37248","name":"Trluml balo angiop 1st vein","description":"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64898","name":"Nrv grf mltst arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more than 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42720","name":"I&d absc phrngl ntraorl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97167","name":"Ot eval high complex 60 min","description":"Occupational therapy evaluation, high complexity, requiring these components: an occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82542","name":"Col chromotography qual/quan","description":"Column chromatography, includes mass spectrometry, if performed (eg, hplc, lc, lc/ms, lc/ms-ms, gc, gc/ms-ms, gc/ms, hplc/ms), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2810.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96151","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3215","name":"Orthopedic ftwear ladies oxf","description":"Orthopedic footwear, ladies shoe, oxford, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99288","name":"Direct advanced life support","description":"Physician or other qualified health care professional direction of emergency medical systems (ems) emergency care, advanced life support","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90870","name":"Electroconvulsive therapy","description":"Electroconvulsive therapy (includes necessary monitoring)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","name":"Anes px art femoral art lig","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54344","name":"Rrp hypspad comp moblj&urtp","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26952","name":"Amputation of finger/thumb","description":"Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (v-y, hood)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6240.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35506","name":"Art byp grft subclav-carotid","description":"Bypass graft, with vein; carotid-subclavian or subclavian-carotid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22845","name":"Insert spine fixation device","description":"Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43135","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55831","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60225","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20703","name":"Rmvl imed rx delivery device","description":"Removal of drug-delivery device(s), intramedullary (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21182","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27831","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21502","name":"I&d dp abs/hmtm nck rib ostc","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; with partial rib ostectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0182","name":"Hospice care supervision","description":"Physician supervision of a patient under a medicare-approved hospice (patient not present) requiring complex and multidisciplinary care modalities involving regular physician development and/or revision of care plans, review of subsequent reports of patient status, review of laboratory and other stu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83634","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19085","name":"Bx breast 1st lesion mr imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35693","name":"Art trnsposj subclavian","description":"Transposition and/or reimplantation; vertebral to subclavian artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96139","name":"Psycl/nrpsyc tst tech ea","description":"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75954","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3895.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45111","name":"Partial removal of rectum","description":"Proctectomy; partial resection of rectum, transabdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24359","name":"Repair elbow deb/attch open","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37200","name":"Transcatheter biopsy","description":"Transcatheter biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45340","name":"Sig w/tndsc balloon dilation","description":"Sigmoidoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99385","name":"Prev visit new age 18-39","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58662","name":"Laparoscopy excise lesions","description":"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27475","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35355","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliofemoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95149","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 single stinging insect venoms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38792","name":"Ra tracer id of sentinl node","description":"Injection procedure; radioactive tracer for identification of sentinel node","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96171","name":"Hlth bhv ivntj fam w/o pt ea","description":"Health behavior intervention, family (without the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92608","name":"Ex for speech device rx addl","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0560T","name":"Antmc mdl 3d print ea addl","description":"Anatomic model 3d-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26530","name":"Revise knuckle joint","description":"Arthroplasty, metacarpophalangeal joint; each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64911","name":"Neurorraphy w/vein autograft","description":"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69632","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (eg, postfenestration)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23540","name":"Cltx acromclav dislc wo mnpj","description":"Closed treatment of acromioclavicular dislocation; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68335","name":"Revise/graft eyelid lining","description":"Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36514","name":"Apheresis plasma","description":"Therapeutic apheresis; for plasma pheresis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3794.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33660","name":"Repair of heart defects","description":"Repair of incomplete or partial atrioventricular canal (ostium primum atrial septal defect), with or without atrioventricular valve repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1528.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27645","name":"Resect tibia tumor","description":"Radical resection of tumor; tibia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61592","name":"Orbitocranial approach/skull","description":"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural elevation of temporal lobe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21137","name":"Rdctj forehead cntrg only","description":"Reduction forehead; contouring only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33960","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33813","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66183","name":"Insert ant drainage device","description":"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64472","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26440","name":"Release palm/finger tendon","description":"Tenolysis, flexor tendon; palm or finger, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50384","name":"Remove ureter stent percut","description":"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69805","name":"Explore inner ear","description":"Endolymphatic sac operation; without shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2757.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81237","name":"Ezh2 gene common variants","description":"Ezh2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large b-cell lymphoma) gene analysis, common variant(s) (eg, codon 646)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36581","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90945","name":"Dialysis one evaluation","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0497T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33233","name":"Removal of pm generator","description":"Removal of permanent pacemaker pulse generator only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14350","name":"Filleted finger/toe flap","description":"Filleted finger or toe flap, including preparation of recipient site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63005","name":"Remove spine lamina 1/2 lmbr","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21423","name":"Optx palatal/max fx comp","description":"Open treatment of palatal or maxillary fracture (lefort i type); complicated (comminuted or involving cranial nerve foramina), multiple approaches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35492","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21743","name":"Repair sternum/nuss w/scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), with thoracoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0091","name":"Obtaining screen pap smear","description":"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20240","name":"Bone biopsy open superficial","description":"Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"40819","name":"Excise lip or cheek fold","description":"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23630","name":"Optx gr hmrl tbrs fx int fix","description":"Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33477","name":"Implant tcat pulm vlv perq","description":"Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0047","name":"Alcohol/drug abuse svc nos","description":"Alcohol and/or other drug abuse services, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6260","name":"Wound cleanser any type/size","description":"Wound cleansers, any type, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"17340","name":"Cryotherapy for acne","description":"Cryotherapy (co2 slush, liquid n2) for acne","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36598","name":"Inj w/fluor eval cv device","description":"Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28415","name":"Optx calcaneal fracture","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33210","name":"Insert electrd/pm cath sngl","description":"Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37248","name":"Trluml balo angiop 1st vein","description":"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32701","name":"Thorax stereo rad targetw/tx","description":"Thoracic target(s) delineation for stereotactic body radiation therapy (srs/sbrt), (photon or particle beam), entire course of treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0151T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27151","name":"Incision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50437","name":"Dilat xst trc new access rcs","description":"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed; including new access into the renal collecting sys","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83901","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39561","name":"Resect diaphragm complex","description":"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89320","name":"Semen anal vol/count/mot","description":"Semen analysis; volume, count, motility, and differential","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G2005","name":"Post-d/c h vst new pt 75 m","description":"Extensive (75 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64400","name":"Njx aa&/strd trigeminal nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; trigeminal nerve, each branch (ie, ophthalmic, maxillary, mandibular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4987.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28090","name":"Removal of foot lesion","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9981","name":"Remote e/m new pt 45mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77416","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45340","name":"Sig w/tndsc balloon dilation","description":"Sigmoidoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0143","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41874","name":"Alveoloplasty each quadrant","description":"Alveoloplasty, each quadrant (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31032","name":"Explore sinus remove polyps","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) with removal of antrochoanal polyps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93526","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33535","name":"Cabg arterial three","description":"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24149","name":"Radical resection of elbow","description":"Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29720","name":"Repair spica body cst/jacket","description":"Repair of spica, body cast or jacket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31553","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, younger than 12 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23412","name":"Repair rotator cuff chronic","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52214","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63198","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27519","name":"Treat thigh fx growth plate","description":"Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96203","name":"Mlt fam grp bhv train ea add","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5797.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54205","name":"Njx px peyronie ds exps plaq","description":"Injection procedure for peyronie disease; with surgical exposure of plaque","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87542","name":"Legion pneumo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97129","name":"Ther ivntj 1st 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65815","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0403","name":"Ekg for initial prevent exam","description":"Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58543","name":"Lsh uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50695","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, with separate nephrostomy catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26615","name":"Treat metacarpal fracture","description":"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43753","name":"Tx gastro intub w/asp","description":"Gastric intubation and aspiration(s) therapeutic, necessitating physicians skill (eg, for gastrointestinal hemorrhage), including lavage if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88363","name":"Xm archive tissue molec anal","description":"Examination and selection of retrieved archival (ie, previously diagnosed) tissue(s) for molecular analysis (eg, kras mutational analysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44021","name":"Decompress small bowel","description":"Enterotomy, small intestine, other than duodenum; for decompression (eg, baker tube)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3405.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34831","name":"Open aortoiliac prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; aorto-bi-iliac prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11597.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82646","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43288","name":"Esphg thrsc moblj","description":"Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, th","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25274","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26392","name":"Repair/graft hand tendon","description":"Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54860","name":"Removal of epididymis","description":"Epididymectomy; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50394","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16030","name":"Dress/debrid p-thick burn l","description":"Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82943","name":"Assay of glucagon","description":"Glucagon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58294","name":"Vag hyst w/enterocele compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37235","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35606","name":"Bpg carotid-subclavian","description":"Bypass graft, with other than vein; carotid-subclavian","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53601","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55862","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61151","name":"Burr hole/treph sbsq tapping","description":"Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31646","name":"Brnchsc w/ther aspir sbsq","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43229","name":"Esophagoscopy lesion ablate","description":"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0246","name":"Followup eval of foot pt lop","description":"Follow-up physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include at least the following: (1) a patient history, (2) a physical examination that includes: (a) visual inspection of the forefoot, hindfoot ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61582","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31715","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15777","name":"Acellular derm matrix implt","description":"Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4928","name":"Surgical mask","description":"Surgical mask, per 20","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33310","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10035","name":"Plmt sft tiss loclzj dev 1st","description":"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2025","name":"Dis site tele svcs rhc/fqhc","description":"Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24125","name":"Exc/crtg b1 cst/tum rds agrf","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64520","name":"N block lumbar/thoracic","description":"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33615","name":"Repair modified fontan","description":"Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple fontan procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41100","name":"Biopsy of tongue","description":"Biopsy of tongue; anterior two-thirds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49000","name":"Exploration of abdomen","description":"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67208","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61635","name":"Intracran angioplsty w/stent","description":"Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28270","name":"Release of foot contracture","description":"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36902","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33548","name":"Restore/remodel ventricle","description":"Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, svr, saver, dor procedures)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51605","name":"Preparation for bladder xray","description":"Injection procedure and placement of chain for contrast and/or chain urethrocystography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95120","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0312","name":"Immunize couns < 21yr 5-15 m","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13827.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0165T","name":"Revise lumb artif disc addl","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00924","name":"Anes male gent undscnd tstis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); undescended testis, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20969","name":"Bone/skin graft microvasc","description":"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80410","name":"Calcitonin stimul panel","description":"Calcitonin stimulation panel (eg, calcium, pentagastrin) this panel must include the following: calcitonin (82308 x 3)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31030","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) without removal of antrochoanal polyps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25020","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; without debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46607","name":"Diagnostic anoscopy & biopsy","description":"Anoscopy; with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57285","name":"Repair paravag defect vag","description":"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49657","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T1015","name":"Clinic service","description":"Clinic visit/encounter, all-inclusive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["HE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21268","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"Office o/p new mod 45 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or excee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5307.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21603","name":"Exc ch wal tum w/lymphadec","description":"Excision of chest wall tumor involving rib(s), with plastic reconstruction; with mediastinal lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11606","name":"Exc tr-ext mal+marg >4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87535","name":"Hiv-1 probe&reverse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58554","name":"Laparo-vag hyst w/t/o compl","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9042","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0034A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0604","name":"Hosp grade elec breast pump","description":"Breast pump, hospital grade, electric (ac and / or dc), any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"80400","name":"Acth stimulation panel","description":"Acth stimulation panel; for adrenal insufficiency this panel must include the following: cortisol (82533 x 2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97164","name":"Pt re-eval est plan care","description":"Re-evaluation of physical therapy established plan of care, requiring these components: an examination including a review of history and use of standardized tests and measures is required; and revised plan of care using a standardized patient assessment instrument and/or measurable assessment of fun","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50240","name":"Nephrectomy partial","description":"Nephrectomy, partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93784","name":"Ambl bp mntr w/software","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; including recording, scanning analysis, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94662","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54308","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0320","name":"Two-way audio and video hhs","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86769","name":"Sars-cov-2 covid-19 antibody","description":"Antibody; severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94720","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2528.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81186","name":"Cacna1a gen known famil vrnt","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; known familial variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48548","name":"Fuse pancreas and bowel","description":"Pancreaticojejunostomy, side-to-side anastomosis (puestow-type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7261","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47532","name":"Injection for cholangiogram","description":"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21343","name":"Open tx dprsd front sinus fx","description":"Open treatment of depressed frontal sinus fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99485","name":"Suprv interfacilty transport","description":"Supervision by a control physician of interfacility transport care of the critically ill or critically injured pediatric patient, 24 months of age or younger, includes two-way communication with transport team before transport, at the referring facility and during the transport, including data inter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49904","name":"Omental flap extra-abdom","description":"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87281","name":"Pneumocystis carinii ag if","description":"Infectious agent antigen detection by immunofluorescent technique; pneumocystis carinii","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77406","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88307","name":"Tissue exam by pathologist","description":"Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone fragment(s), pathologic fracture brain, biopsy brain/meninges, tumor resection breast, excision of lesion, requiring microscopic evaluation of surgical margins breast, mastectomy - partia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42200","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, soft and/or hard palate only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95834","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53448","name":"Remov/replc ur sphinctr comp","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of infected tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92601","name":"Cochlear implt f/up exam <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93352","name":"Admin ecg contrast agent","description":"Use of echocardiographic contrast agent during stress echocardiography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2847.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0042T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6004","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81327","name":"Sept9 gen prmtr mthyltn alys","description":"Sept9 (septin9) (eg, colorectal cancer) promoter methylation analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26746","name":"Treat finger fracture each","description":"Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15136","name":"Drm agrft f/s/n/h/f/g/m ea","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31515","name":"Laryngoscopy for aspiration","description":"Laryngoscopy direct, with or without tracheoscopy; for aspiration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2748.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21247","name":"Reconstruct lower jaw bone","description":"Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0419T","name":"Dstrj neurofibroma xtnsv","description":"Destruction of neurofibroma, extensive (cutaneous, dermal extending into subcutaneous); face, head and neck, greater than 50 neurofibromas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29902","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, stener lesion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26340","name":"Manipulate finger w/anesth","description":"Manipulation, finger joint, under anesthesia, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0217T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64463","name":"Pvb thoracic cont infusion","description":"Paravertebral block (pvb) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93462","name":"L hrt cath trnsptl puncture","description":"Left heart catheterization by transseptal puncture through intact septum or by transapical puncture (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0212T","name":"Compre audiometry evaluation","description":"Comprehensive audiometry threshold evaluation and speech recognition (0209t, 0211t combined), automated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93508","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44314","name":"Revision of ileostomy","description":"Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25251","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; complicated, including total wrist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87186","name":"Sc std microdil/agar dil","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [mic] or breakpoint), each multi-antimicrobial, per plate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0414","name":"Pelvic ring fx treat int fix","description":"Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41130","name":"Partial removal of tongue","description":"Glossectomy; hemiglossectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26415","name":"Excision hand/finger tendon","description":"Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1992.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33771","name":"Rpr tga w/surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular septal defect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92582","name":"Conditioning play audiometry","description":"Conditioning play audiometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33416","name":"Revise ventricle muscle","description":"Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8688","name":"Implt nrostm pls gen dua non","description":"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7239.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57160","name":"Insert pessary/other device","description":"Fitting and insertion of pessary or other intravaginal support device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34800","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49595","name":"Rpr aa hrn 1st > 10 rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33401","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33989","name":"Removal of left heart vent","description":"Removal of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53445","name":"Insert uro/ves nck sphincter","description":"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27328","name":"Exc thigh/knee tum deep <5cm","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45387","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80185","name":"Assay of phenytoin total","description":"Phenytoin; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19084","name":"Bx breast add lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26442","name":"Release palm & finger tendon","description":"Tenolysis, flexor tendon; palm and finger, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48552","name":"Prep donor pancreas/venous","description":"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84560","name":"Assay of urine/uric acid","description":"Uric acid; other source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43400","name":"Ligate esophagus veins","description":"Ligation, direct, esophageal varices","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2325.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4526.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15851","name":"Removal sutr/staple req anes","description":"Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96367","name":"Tx/proph/dg addl seq iv inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41800","name":"Drainage of gum lesion","description":"Drainage of abscess, cyst, hematoma from dentoalveolar structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0513","name":"Prolong prev svcs, first 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; first 30 minutes (list separately in addition to code for preventive service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31630","name":"Bronchoscopy dilate/fx repr","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28039","name":"Exc foot/toe tum sc 1.5 cm/>","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29824","name":"Sho arthrs srg dstl claviclc","description":"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35800","name":"Explore neck vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6747.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36834","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27047","name":"Exc hip/pelvis les sc < 3 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87273","name":"Herpes simplex 2 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 2","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35363","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9505","name":"Tl201 thallium","description":"Thallium tl-201 thallous chloride, diagnostic, per millicurie","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27111","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to femoral neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8505","name":"Artificial larynx, accessory","description":"Artificial larynx replacement battery / accessory, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15116","name":"Epdrm agrft f/s/n/h/f/g/m ea","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33993","name":"Reposg perq r/l hrt vad","description":"Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64714","name":"Revise low back nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99465","name":"Nb resuscitation","description":"Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22319","name":"Treat odontoid fx w/graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1663.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89322","name":"Semen anal strict criteria","description":"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, kruger)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32659","name":"Thoracoscopy w/sac drainage","description":"Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11022.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10021","name":"Fna bx w/o img gdn 1st les","description":"Fine needle aspiration biopsy, without imaging guidance; first lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34820","name":"Opn iliac art expos","description":"Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26035","name":"Decompress fingers/hand","description":"Decompression fingers and/or hand, injection injury (eg, grease gun)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28002","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; single bursal space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95709","name":"Eeg w/o vid ea 12-26hr intmt","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29515","name":"Application short leg splint","description":"Application of short leg splint (calf to foot)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2500.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85292","name":"Clot factor fletcher fact","description":"Clotting; prekallikrein assay (fletcher factor assay)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27267","name":"Cltx thigh fx","description":"Closed treatment of femoral fracture, proximal end, head; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44110","name":"Excise intestine lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; single enterotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22812","name":"Arthrd ant dfrm 8+ vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"49904","name":"Omental flap extra-abdom","description":"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43248","name":"Egd guide wire insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1206","name":"Topical fluoride varnish","description":"Topical fluoride varnish; therapeutic application for moderate to high caries risk patients","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61322","name":"Crnec/crnot dcmprv w/o lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67331","name":"Eye surgery follow-up add-on","description":"Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47536","name":"Exchange biliary drg cath","description":"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90474","name":"Immune admin oral/nasal addl","description":"Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6524.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62360","name":"Insert spine infusion device","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37238","name":"Open/perq place stent same","description":"Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28160","name":"Partial removal of toe","description":"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58321","name":"Artificial insemination","description":"Artificial insemination; intra-cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32442","name":"Sleeve pneumonectomy","description":"Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0421","name":"Ed svc ckd grp per session","description":"Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64613","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43360","name":"Gastrointestinal repair","description":"Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0339","name":"Robot lin-radsurg com, first","description":"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27664","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57454","name":"Bx/curett of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11732","name":"Avlsn nail plate simple each","description":"Avulsion of nail plate, partial or complete, simple; each additional nail plate (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25320","name":"Repair/revise wrist joint","description":"Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49436","name":"Embedded ip cath exit-site","description":"Delayed creation of exit site from embedded subcutaneous segment of intraperitoneal cannula or catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43030","name":"Cricopharyngeal myotomy","description":"Cricopharyngeal myotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22112","name":"Remove part thorax vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93313","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); placement of transesophageal probe only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86860","name":"Rbc antibody elution","description":"Antibody elution (rbc), each elution","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96912","name":"Photochemotherapy puva","description":"Photochemotherapy; psoralens and ultraviolet a (puva)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12041","name":"Intmd rpr n-hf/genit 2.5cm/<","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47362","name":"Repair liver wound","description":"Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54360","name":"Penis plastic surgery","description":"Plastic operation on penis to correct angulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63075","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86665","name":"Epstein-barr capsid vca","description":"Antibody; epstein-barr (eb) virus, viral capsid (vca)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58240","name":"Removal of pelvis contents","description":"Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2482.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99420","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"Spirometry up to 2 yrs old","description":"Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3588.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82658","name":"Enzyme cell activity ra","description":"Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; radioactive substrate, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43266","name":"Egd endoscopic stent place","description":"Esophagogastroduodenoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4036","name":"Enteral feed sup kit grav by","description":"Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40650","name":"Rpr lip fth vermilion only","description":"Repair lip, full thickness; vermilion only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1496.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22110","name":"Remove part of neck vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27700","name":"Revision of ankle joint","description":"Arthroplasty, ankle;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77768","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter over 2.0 cm and 2 or more channels, or multiple lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4530","name":"Ped size brief/diaper lg","description":"Pediatric sized disposable incontinence product, brief/diaper, large size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82485","name":"Assay chondroitin sulfate","description":"Chondroitin b sulfate, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0546T","name":"Rf spectrsc ntraop mrgn asmt","description":"Radiofrequency spectroscopy, real time, intraoperative margin assessment, at the time of partial mastectomy, with report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87497","name":"Cytomeg dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0499T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88738","name":"Hgb quant transcutaneous","description":"Hemoglobin (hgb), quantitative, transcutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99151","name":"Mod sed same phys/qhp <5 yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27230","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35651","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4238","name":"Adju cgm supply allowance","description":"Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43763","name":"Rplc gtube revj gstrst trc","description":"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; requiring revision of gastrostomy tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61760","name":"Implant brain electrodes","description":"Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44382","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G9984","name":"Remote e/m est. pt  15mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98976","name":"Rtm dev sply resp sys 16-30d","description":"Remote therapeutic monitoring (eg, therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of respiratory system, 16-30 days in a 30-day period","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64896","name":"Nrv grf mltst hnd/foot >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26561","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps and grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7486.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33692","name":"Comp rpr tof wo pulm atresia","description":"Complete repair tetralogy of fallot without pulmonary atresia;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76810","name":"Ob us >/= 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4164","name":"Parenteral 50% dextrose solu","description":"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0570T","name":"Ttvr perq ea addl prosth","description":"Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50250","name":"Opn abltj 1/> rnl mas crysrg","description":"Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49041","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29847","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; internal fixation for fracture or instability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26776","name":"Pin finger dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47700","name":"Exploration of bile ducts","description":"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65750","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in aphakia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2158.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66600","name":"Remove iris and lesion","description":"Iridectomy, with corneoscleral or corneal section; for removal of lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2232.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63172","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84138","name":"Assay of pregnanetriol","description":"Pregnanetriol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15775","name":"Hair trnspl 1-15 punch grfts","description":"Punch graft for hair transplant; 1 to 15 punch grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99183","name":"Hyperbaric oxygen therapy","description":"Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83003","name":"Assay growth hormone (hgh)","description":"Growth hormone, human (hgh) (somatotropin)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37249","name":"Trluml balo angiop addl vein","description":"Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; each additional vein (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80162","name":"Assay of digoxin total","description":"Digoxin; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3296.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47541","name":"Plmt access bil tree sm bwl","description":"Placement of access through the biliary tree and into small bowel to assist with an endoscopic biliary procedure (eg, rendezvous procedure), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological superv","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2826.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81185","name":"Cacna1a gene full gene seq","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; full gene sequence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50693","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36400","name":"Vnpnxr<3yrs phy/qhp fem/jug","description":"Venipuncture, younger than age 3 years, necessitating the skill of a physician or other qualified health care professional, not to be used for routine venipuncture; femoral or jugular vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3268.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99173","name":"Visual acuity screen","description":"Screening test of visual acuity, quantitative, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11642","name":"Exc f/e/e/n/l mal+mrg 1.1-2","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28636","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99309","name":"Sbsq nf care moderate mdm 30","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85337","name":"Thrombomodulin","description":"Thrombomodulin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61154","name":"Burr hole w/evac&/drg hmtma","description":"Burr hole(s) with evacuation and/or drainage of hematoma, extradural or subdural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25240","name":"Partial removal of ulna","description":"Excision distal ulna partial or complete (eg, darrach type or matched resection)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15838","name":"Exc excsv submental fat pad","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43124","name":"Removal of esophagus","description":"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43300","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28296","name":"Cor hlx vlgs dstl mtar osteo","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43281","name":"Lap paraesophag hern repair","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40816","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90947","name":"Dialysis repeated eval","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0001","name":"Alcohol and/or drug assess","description":"Alcohol and/or drug assessment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35540","name":"Art byp grft aortbifemoral","description":"Bypass graft, with vein; aortobifemoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31631","name":"Bronchoscopy dilate w/stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69806","name":"Explore inner ear","description":"Endolymphatic sac operation; with shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33460","name":"Revision of tricuspid valve","description":"Valvectomy, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86226","name":"Dna antibody single strand","description":"Deoxyribonucleic acid (dna) antibody; single stranded","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33746","name":"Tis cgen car anomal ea addl","description":"Transcatheter intracardiac shunt (tis) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67220","name":"Treatment of choroid lesion","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94370","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82742","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87480","name":"Candida dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10022","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58275","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86829","name":"Hla class i/ii antibody qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to hla class i or class ii hla antigens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3530.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44312","name":"Revision of ileostomy","description":"Revision of ileostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4589.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85290","name":"Clot factor xiii fibrin stab","description":"Clotting; factor xiii (fibrin stabilizing)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35286","name":"Rpr blvsl grf oth/th vn lxtr","description":"Repair blood vessel with graft other than vein; lower extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84484","name":"Assay of troponin quant","description":"Troponin, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1946.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77407","name":"Radiation tx delivery lvl 2","description":"Radiation treatment delivery; level 2, single-isocenter (eg, 3d or imrt), photons, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36223","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36558","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; age 5 years or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0421T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66179","name":"Aqueous shunt eye w/o graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25265","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96373","name":"Ther/proph/diag inj ia","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26426","name":"Repair finger/hand tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64494","name":"Inj paravert f jnt l/s 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95971","name":"Alys smpl sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63044","name":"Laminotomy addl lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional lumbar interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2617","name":"Custom fab w/c back cushion","description":"Custom fabricated wheelchair back cushion, any size, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25600","name":"Cltx dst rdl fx/ephys sep wo","description":"Closed treatment of distal radial fracture (eg, colles or smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35631","name":"Bpg aor-celiac-msn-renal","description":"Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82651","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15572","name":"Skin pedicle flap arms/legs","description":"Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61863","name":"Implant neuroelectrode","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; first array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62161","name":"Dissect brain w/scope","description":"Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, or removal of ventricular catheter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9979","name":"Remote e/m new pt 20mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: an expanded problem focused history;  an expanded problem focused e","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7178.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33414","name":"Repair of aortic valve","description":"Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23625","name":"Cltx gr hmrl tbrs fx w/mnpj","description":"Closed treatment of greater humeral tuberosity fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2456.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15576","name":"Pedicle e/n/e/l/ntroral","description":"Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8902","name":"Mra w/o fol w/cont, abd","description":"Magnetic resonance angiography without contrast followed by with contrast, abdomen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11667.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2285.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41520","name":"Reconstruction tongue fold","description":"Frenoplasty (surgical revision of frenum, eg, with z-plasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61592","name":"Orbitocranial approach/skull","description":"Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural elevation of temporal lobe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2863.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69806","name":"Explore inner ear","description":"Endolymphatic sac operation; with shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64449","name":"Njx aa&/strd lmbr plex nfs","description":"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89130","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11971","name":"Rmvl tis xpndr wo insj implt","description":"Removal of tissue expander without insertion of implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2066","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0218T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32110","name":"Explore/repair chest","description":"Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11839.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33880","name":"Evasc rpr ta ndgft cov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft covering the left subclavian artery and all aortic tube endograft e","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42815","name":"Excision of neck cyst","description":"Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43635","name":"Removal of stomach partial","description":"Vagotomy when performed with partial distal gastrectomy (list separately in addition to code[s] for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45126","name":"Pelvic exenteration","description":"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86804","name":"Hep c ab test confirm","description":"Hepatitis c antibody; confirmatory test (eg, immunoblot)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97163","name":"Pt eval high complex 45 min","description":"Physical therapy evaluation: high complexity, requiring these components: a history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures addressing a total of 4 or more elements from","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46916","name":"Cryosurgery anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86316","name":"Immunoassay tumor other","description":"Immunoassay for tumor antigen, other antigen, quantitative (eg, ca 50, 72-4, 549), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20975","name":"Estim aid bone healg invasiv","description":"Electrical stimulation to aid bone healing; invasive (operative)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80154","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35103","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60502","name":"Re-explore parathyroids","description":"Parathyroidectomy or exploration of parathyroid(s); re-exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8914","name":"Mra w/o fol w/cont, lwr ext","description":"Magnetic resonance angiography without contrast followed by with contrast, lower extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66020","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); air or liquid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84160","name":"Assay of protein any source","description":"Protein, total, by refractometry, any source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61321","name":"Crnec/crnot drg icr abs ittl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6208","name":"Contact layer > 48 sq in","description":"Contact layer, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81204","name":"Ar gene charac alleles","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21451","name":"Cltx mndblr fx w/mnpj","description":"Closed treatment of mandibular fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45383","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78432","name":"Myocrd img pet 2rtracer","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5877.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4087","name":"Gastro/jejuno tube, std","description":"Gastrostomy/jejunostomy tube, standard, any material, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"36015","name":"Place catheter in artery","description":"Selective catheter placement, segmental or subsegmental pulmonary artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44721","name":"Prep donor intestine/artery","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89235","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97761","name":"Prosthetic traing 1st enc","description":"Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94775","name":"Ped home apnea mntr att only","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitor attachment only (includes hook-up, initiation of recording and disconnection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7266","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27842","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3230","name":"Custom shoes depth inlay","description":"Orthopedic footwear, custom shoe, depth inlay, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23680","name":"Optx sho dislc neck fx fixj","description":"Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86156","name":"Cold agglutinin screen","description":"Cold agglutinin; screen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32035","name":"Thoracostomy w/rib resection","description":"Thoracostomy; with rib resection for empyema","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15931","name":"Exc sacral pr ulc prim sutr","description":"Excision, sacral pressure ulcer, with primary suture;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2780.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25820","name":"Arthrd wrist lmtd w/o b1 grf","description":"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33866","name":"Aortic hemiarch graft","description":"Aortic hemiarch graft including isolation and control of the arch vessels, beveled open distal aortic anastomosis extending under one or more of the arch vessels, and total circulatory arrest or isolated cerebral perfusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81518","name":"Onc brst mrna 11 genes","description":"Oncology (breast), mrna, gene expression profiling by real-time rt-pcr of 11 genes (7 content and 4 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithms reported as percentage risk for metastatic recurrence and likelihood of benefit from extended endocrine therapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25445","name":"Arthrp w/prostc trapezium","description":"Arthroplasty with prosthetic replacement; trapezium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3899.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11363.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9751.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96159","name":"Hlth bhv ivntj indiv ea addl","description":"Health behavior intervention, individual, face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4813.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27215","name":"Treat pelvic fracture(s)","description":"Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86771","name":"Shigella antibody","description":"Antibody; shigella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26608","name":"Treat metacarpal fracture","description":"Percutaneous skeletal fixation of metacarpal fracture, each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97535","name":"Self care mngment training","description":"Self-care/home management training (eg, activities of daily living (adl) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34203","name":"Removal of leg artery clot","description":"Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3995.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61519","name":"Remove brain lining lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8101","name":"Spacer with mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; with mask","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28054","name":"Biopsy of toe joint lining","description":"Arthrotomy with biopsy; interphalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01940","name":"Anes nulyt agt lmbr/sac","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0102T","name":"Esw phy anes lat hmrl epcndl","description":"Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5199.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87809","name":"Adenovirus assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40510","name":"Partial excision of lip","description":"Excision of lip; transverse wedge excision with primary closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45825","name":"Repair fistula w/colostomy","description":"Closure of rectourethral fistula; with colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"30130","name":"Excise inferior turbinate","description":"Excision inferior turbinate, partial or complete, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86329","name":"Immunodiffusion nes","description":"Immunodiffusion; not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81167","name":"Brca2 gene full dup/del alys","description":"Brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40831","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; over 2.5 cm or complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2634.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3342.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75558","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87516","name":"Hepatitis b dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15576","name":"Pedicle e/n/e/l/ntroral","description":"Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94780","name":"Cars/bd tst inft-12mo 60 min","description":"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0283","name":"Elec stim other than wound","description":"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0054T","name":"Bone srgry cmptr fluor image","description":"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15301","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75724","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27524","name":"Treat kneecap fracture","description":"Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87804","name":"Influenza assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; influenza","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43279","name":"Lap myotomy heller","description":"Laparoscopy, surgical, esophagomyotomy (heller type), with fundoplasty, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24365","name":"Reconstruct head of radius","description":"Arthroplasty, radial head;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65155","name":"Reinsert ocular implant","description":"Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99368","name":"Team conf w/o pat by hc pro","description":"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66625","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95936","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87101","name":"Skin fungi culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28250","name":"Revision of foot fascia","description":"Division of plantar fascia and muscle (eg, steindler stripping) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68320","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29860","name":"Hip arthroscopy dx","description":"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43621","name":"Removal of stomach","description":"Gastrectomy, total; with roux-en-y reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52281","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21812","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51585","name":"Removal of bladder & nodes","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61548","name":"Removal of pituitary gland","description":"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37216","name":"Transcath stent cca w/o eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; without distal embolic protection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27475","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27495","name":"Reinforce thigh","description":"Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2800.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82941","name":"Assay of gastrin","description":"Gastrin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38210","name":"T-cell depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, t-cell depletion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26990","name":"Drainage of pelvis lesion","description":"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21337","name":"Closed tx septal&nose fx","description":"Closed treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35572","name":"Harvest femoropopliteal vein","description":"Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction procedure (eg, aortic, vena caval, coronary, peripheral artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1876","name":"Stent, non-coa/non-cov w/del","description":"Stent, non-coated/non-covered, with delivery system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11305","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61609","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21557","name":"Resect neck thorax tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52260","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27443","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29887","name":"Arthrs knee srg drlg od fixj","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12004","name":"Rpr s/n/ax/gen/trk7.6-12.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45320","name":"Proctosigmoidoscopy ablate","description":"Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23044","name":"Arthrt ac sc jt exp/rmvl fb","description":"Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69801","name":"Incise inner ear","description":"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64761","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42450","name":"Excise sublingual gland","description":"Excision of sublingual gland","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99251","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64680","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6230","name":"Gauze > 48 sq in water/salne","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64488","name":"Tap block bi injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by injections (includes imaging guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29895","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69433","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3911","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69222","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21700","name":"Revision of neck muscle","description":"Division of scalenus anticus; without resection of cervical rib","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4168","name":"Parenteral sol amino acid 3.","description":"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15610","name":"Delay flap arms/legs","description":"Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27557","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27036","name":"Capsulectomy/capsulotomy hip","description":"Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33234","name":"Removal of pacemaker system","description":"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43756","name":"Dx duod intub w/asp spec","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; single specimen (eg, bile study for crystals or afferent loop culture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8685","name":"Implt nrostm pls gen sng rec","description":"Implantable neurostimulator pulse generator, single array, rechargeable, includes extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"40702","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0578T","name":"Rem interrog dev icds phys","description":"Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33472","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35518","name":"Art byp grft axillary-axilry","description":"Bypass graft, with vein; axillary-axillary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23155","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35490","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43236","name":"Uppr gi scope w/submuc inj","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69642","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64611","name":"Chemodenerv saliv glands","description":"Chemodenervation of parotid and submandibular salivary glands, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1901","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49441","name":"Place duod/jej tube perc","description":"Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36835","name":"Insertion thomas shunt","description":"Insertion of thomas shunt (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82607","name":"Vitamin b-12","description":"Cyanocobalamin (vitamin b-12);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27520","name":"Treat kneecap fracture","description":"Closed treatment of patellar fracture, without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1189.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31235","name":"Nsl/sins ndsc dx sphn sinusc","description":"Nasal/sinus endoscopy, diagnostic; with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61624","name":"Tcat perm occls/embolj cns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37231","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63030","name":"Lamot dcmprn nrv rt 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81186","name":"Cacna1a gen known famil vrnt","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; known familial variant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25120","name":"Removal of forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77412","name":"Radiation tx delivery lvl 3","description":"Radiation treatment delivery; level 3, multiple isocenters with photon therapy (eg, 2d, 3d, or imrt) or a single-isocenter photon therapy (eg, 3d or imrt) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed","date_of_service":"2026-06-06","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":292.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3561.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1266.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44206","name":"Lap part colectomy w/stoma","description":"Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36010","name":"Place catheter in vein","description":"Introduction of catheter, superior or inferior vena cava","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27602","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31649","name":"Bronchial valve remov addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86904","name":"Blood typing patient serum","description":"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24342","name":"Repair of ruptured tendon","description":"Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58145","name":"Myomectomy vag method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21182","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20816","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8645.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2136.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1898.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27395","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92651","name":"Aep hearing status deter i&r","description":"Auditory evoked potentials; for hearing status determination, broadband stimuli, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45825","name":"Repair fistula w/colostomy","description":"Closure of rectourethral fistula; with colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27043","name":"Exc hip pelvis les sc 3 cm/>","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0247","name":"Routine footcare pt w lops","description":"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wou","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40814","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28760","name":"Fusion of big toe joint","description":"Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, jones type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92984","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2065","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86663","name":"Epstein-barr antibody","description":"Antibody; epstein-barr (eb) virus, early antigen (ea)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50081","name":"Perq nl/pl lithotrp cplx>2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, co","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75685","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62327","name":"Njx interlaminar lmbr/sac","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27105","name":"Transfer of spinal muscle","description":"Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90823","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11446","name":"Exc face-mm b9+marg >4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31030","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) without removal of antrochoanal polyps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86336","name":"Inhibin a","description":"Inhibin a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479T","name":"Fxjl abl lsr 1st 100 sq cm","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90911","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9157","name":"Transesoph doppl cardiac mon","description":"Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28302","name":"Incision of ankle bone","description":"Osteotomy; talus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21933","name":"Exc back tum deep 5 cm/>","description":"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87339","name":"H pylori ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42415","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28286","name":"Repair of hammertoe","description":"Correction, cock-up fifth toe, with plastic skin closure (eg, ruiz-mora type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46930","name":"Destroy internal hemorrhoids","description":"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21183","name":"Reconstruct cranial bone","description":"Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85613","name":"Russell viper venom diluted","description":"Russell viper venom time (includes venom); diluted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0566T","name":"Autol cell implt adps njx","description":"Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; injection of cellular implant into knee joint including ultrasound guidance, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35721","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473T","name":"Reprgrmg io rta eltrd ra","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg, retinal prosthesis), in person, including reprogramming and visual training, when performed, with review and report by a qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30124","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; simple, skin, subcutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0181","name":"Home health care supervision","description":"Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86631","name":"Chlamydia antibody","description":"Antibody; chlamydia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43238","name":"Egd us fine needle bx/aspir","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62117","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2796.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23462","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with coracoid process transfer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40800","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42831","name":"Removal of adenoids","description":"Adenoidectomy, primary; age 12 or over","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61591","name":"Infratemporal approach/skull","description":"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resection of sigmoid sinus, with or without decompression and/or mobilization of contents of auditory cana","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27827","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87430","name":"Strep a ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; streptococcus, group a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3001","name":"Screening pap smear by phys","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29590","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35103","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7830.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55600","name":"Vesiculotomy","description":"Vesiculotomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36223","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29914","name":"Hip arthro w/femoroplasty","description":"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61537","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0507T","name":"Near ifr 2img mibmn glnd i&r","description":"Near infrared dual imaging (ie, simultaneous reflective and transilluminated light) of meibomian glands, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43286","name":"Esphg tot w/laps moblj","description":"Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic transhiatal esophagectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96406","name":"Chemo intralesional over 7","description":"Chemotherapy administration; intralesional, more than 7 lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22842","name":"Insert spine fixation device","description":"Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22101","name":"Remove part thorax vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1487.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27886","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; re-amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95851","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49402","name":"Remove foreign body adbomen","description":"Removal of peritoneal foreign body from peritoneal cavity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31624","name":"Dx bronchoscope/lavage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0022","name":"Comm hlth intg svs add 30 m","description":"Community health integration services, each additional 30 minutes per calendar month (list separately in addition to g0019)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45315","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64462","name":"Pvb thoracic 2nd+ inj site","description":"Paravertebral block (pvb) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36222","name":"Place cath carotid/inom art","description":"Selective catheter placement, common carotid or innominate artery, unilateral, any approach, with angiography of the ipsilateral extracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47420","name":"Incision of bile duct","description":"Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0407","name":"Inpt/tele follow up 25","description":"Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15976.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81345","name":"Tert gene targeted seq alys","description":"Tert (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8424","name":"Ready gradient sleeve","description":"Gradient pressure aid (sleeve), ready made","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KL","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55060","name":"Repair of hydrocele","description":"Repair of tunica vaginalis hydrocele (bottle type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77373","name":"Strtctc bdy rad ther tx dlvr","description":"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28530","name":"Treat sesamoid bone fracture","description":"Closed treatment of sesamoid fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33853","name":"Rpr hypopl a-arch w/byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99422","name":"Ol dig e/m svc 11-20 min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93226","name":"Xtrnl ecg rec<48 hr scan a/r","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93524","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4026.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50562","name":"Renal scope w/tumor resect","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3727.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26341","name":"Manipulat palm cord post inj","description":"Manipulation, palmar fascial cord (ie, dupuytrens cord), post enzyme injection (eg, collagenase), single cord","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15156","name":"Tis clt agrft f/s/n/h/f/g ad","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85536","name":"Iron stain peripheral blood","description":"Iron stain, peripheral blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64416","name":"Njx aa&/strd brch pl nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; brachial plexus, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41510","name":"Tongue to lip surgery","description":"Suture of tongue to lip for micrognathia (douglas type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63075","name":"Neck spine disk surgery","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42281","name":"Insertion palate prosthesis","description":"Insertion of pin-retained palatal prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49495","name":"Rpr ing hernia baby reduc","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47537","name":"Removal biliary drg cath","description":"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67027","name":"Implant eye drug system","description":"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66762","name":"Revision of iris","description":"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1750.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94662","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43237","name":"Endoscopic us exam esoph","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69205","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; with general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27416","name":"Osteochondral knee autograft","description":"Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30410","name":"Reconstruction of nose","description":"Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32660","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27715","name":"Ostpl tibfib lngth/shrt","description":"Osteoplasty, tibia and fibula, lengthening or shortening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83499","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33243","name":"Remove eltrd/thoracotomy","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3412.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43117","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty (ivor lewis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26111","name":"Exc hand les sc 1.5 cm/>","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83516","name":"Immunoassay nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"18583","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36904","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53505","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; penile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28020","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"20702","name":"Mnl prep&insj imed rx dev","description":"Manual preparation and insertion of drug-delivery device(s), intramedullary (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57455","name":"Biopsy of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92586","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21355","name":"Perq tx malar fracture","description":"Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0324","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90840","name":"Psytx crisis ea addl 30 min","description":"Psychotherapy for crisis; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88172","name":"Cytp dx eval fna 1st ea site","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, first evaluation episode, each site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50830","name":"Revise urine flow","description":"Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3603.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27279","name":"Arthrd si jt plmt tartclr dv","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46288","name":"Repair anal fistula","description":"Closure of anal fistula with rectal advancement flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15201","name":"Fth/gft fr trnk each addl","description":"Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51841","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); complicated (eg, secondary repair)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"57100","name":"Biopsy vaginal mucosa simple","description":"Biopsy of vaginal mucosa; simple (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28476","name":"Prq skel fix metar fx w/mnpj","description":"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45160","name":"Excision of rectal lesion","description":"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32650","name":"Thoracoscopy w/pleurodesis","description":"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11772","name":"Exc pilonidal cyst comp","description":"Excision of pilonidal cyst or sinus; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0315","name":"Counsel immune <21  5-15 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44720","name":"Prep donor intestine/venous","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47540","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30150","name":"Rhinectomy partial","description":"Rhinectomy; partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99366","name":"Team conf w/pat by hc prof","description":"Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2087","name":"Off base opioid tx, 60 m","description":"Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34812","name":"Opn fem art expos","description":"Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36585","name":"Replace picvad cath","description":"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36516","name":"Apheresis immunoads slctv","description":"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25606","name":"Perq skel fixj dstl rdl fx","description":"Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2363.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0891","name":"Pwc gp5 ped mult pow opt s/b","description":"Power wheelchair, group 5 pediatric, multiple power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94775","name":"Ped home apnea mntr att only","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitor attachment only (includes hook-up, initiation of recording and disconnection)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27638","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4672","name":"Drainage ext line, dialysis","description":"Drainage extension line, sterile, for dialysis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26235","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82671","name":"Assay of estrogens","description":"Estrogens; fractionated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5635.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21433","name":"Optx cranfcl sep comp mlt","description":"Open treatment of craniofacial separation (lefort iii type); complicated (eg, comminuted or involving cranial nerve foramina), multiple surgical approaches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27330","name":"Biopsy knee joint lining","description":"Arthrotomy, knee; with synovial biopsy only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46270","name":"Remove anal fist subq","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64486","name":"Tap block unil by injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87511","name":"Gardner vag dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21010","name":"Incision of jaw joint","description":"Arthrotomy, temporomandibular joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96369","name":"Sc ther infusion up to 1 hr","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27301","name":"Drain thigh/knee lesion","description":"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6230","name":"Gauze > 48 sq in water/salne","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84022","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"53020","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); except infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93722","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99411","name":"Preventive counseling group","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90811","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27784","name":"Treatment of fibula fracture","description":"Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58943","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11623","name":"Exc s/n/h/f/g mal+mrg 2.1-3","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6198","name":"Alginate dressing > 48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17263","name":"Dstrj mal les t/a/l 2.1-3.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50395","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54316","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27513","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0054T","name":"Bone srgry cmptr fluor image","description":"Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96103","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9870","name":"Cmmi asyntelehealth >20min","description":"Receipt and analysis of remote, asynchronous images for dermatologic and/or ophthalmologic evaluation, for use only in a medicare-approved cmmi model, more than 20 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57522","name":"Conization of cervix","description":"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01630","name":"Anes opn/arthr px sho jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50020","name":"Drg perirnl/renal absc open","description":"Drainage of perirenal or renal abscess, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9016","name":"Rbc leukocytes reduced","description":"Red blood cells, leukocytes reduced, each unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33507","name":"Repair art intramural","description":"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61585","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36254","name":"Ins cath ren art 2nd+ bilat","description":"Superselective catheter placement (one or more second order or higher renal artery branches) renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture, catheterization, fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, an","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64450","name":"Njx aa&/strd other pn/branch","description":"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88741","name":"Transcutaneous methb","description":"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41821","name":"Excision of gum flap","description":"Operculectomy, excision pericoronal tissues","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65140","name":"Attach ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles attached to implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01484","name":"Anes opn lw l/a/f oste/ostpl","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"Prev visit new age 5-11","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29892","name":"Arthrs aid rpr od les/tib fx","description":"Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87913","name":"Nfct agt gntyp alys sarscov2","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), mutation identification in targeted region(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27138","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; femoral component only, with or without allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31526","name":"Dx laryngoscopy w/oper scope","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87476","name":"Lyme dis dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31276","name":"Nsl/sins ndsc frnt tiss rmvl","description":"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28106","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43277","name":"Ercp ea duct/ampulla dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, each duct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2625.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96360","name":"Hydration iv infusion init","description":"Intravenous infusion, hydration; initial, 31 minutes to 1 hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37761","name":"Ligate leg veins open","description":"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85441","name":"Heinz bodies direct","description":"Heinz bodies; direct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27702","name":"Reconstruct ankle joint","description":"Arthroplasty, ankle; with implant (total ankle)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43401","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99374","name":"Home health care supervision","description":"Supervision of a patient under care of home health agency (patient not present) in home, domiciliary or equivalent environment (eg, alzheimers facility) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81275","name":"Kras gene variants exon 2","description":"Kras (kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; variants in exon 2 (eg, codons 12 and 13)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99156","name":"Mod sed oth phys/qhp 5/>yrs","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 year","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53010","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4100","name":"Food thickener oral","description":"Food thickener, administered orally, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77404","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47801","name":"Placement bile duct support","description":"Placement of choledochal stent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57210","name":"Repair vagina/perineum","description":"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54318","name":"Reconstruction of urethra","description":"Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage cecil repair)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92626","name":"Eval aud funcj 1st hour","description":"Evaluation of auditory function for surgically implanted device(s) candidacy or postoperative status of a surgically implanted device(s); first hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39502","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21725","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; with cast application","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0076","name":"Care manag h vst new pt 20 m","description":"Brief (20 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93793","name":"Anticoag mgmt pt warfarin","description":"Anticoagulant management for a patient taking warfarin, must include review and interpretation of a new home, office, or lab international normalized ratio (inr) test result, patient instructions, dosage adjustment (as needed), and scheduling of additional test(s), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15176","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4875.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77401","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP23","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27077","name":"Resect hip tum w/innom bone","description":"Radical resection of tumor; innominate bone, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54316","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1732.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35390","name":"Reoperation carotid add-on","description":"Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21172","name":"Rcnst supr-lat orb rm&lw fhd","description":"Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49591","name":"Rpr aa hrn 1st < 3 cm rdc","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); less than 3 cm, reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0145T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3727.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV","AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0449T","name":"Insj aqueous drain dev 1st","description":"Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into the subconjunctival space; initial device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95250","name":"Cont gluc mntr phys/qhp eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and pr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84080","name":"Assay alkaline phosphatases","description":"Phosphatase, alkaline; isoenzymes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51080","name":"Drainage of bladder abscess","description":"Drainage of perivesical or prevesical space abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1892.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49180","name":"Biopsy abdominal mass","description":"Biopsy, abdominal or retroperitoneal mass, percutaneous needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43502","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, mallory-weiss)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64491","name":"Inj paravert f jnt c/t 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36860","name":"External cannula declotting","description":"External cannula declotting (separate procedure); without balloon catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35523","name":"Art byp grft brchl-ulnr-rdl","description":"Bypass graft, with vein; brachial-ulnar or -radial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28112","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; other metatarsal head (second, third or fourth)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5536.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1063.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83905","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58120","name":"Dilation and curettage","description":"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4723","name":"Dialys sol fld vol > 2999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71270","name":"Ct thorax dx c-/c+","description":"Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35538","name":"Art byp grft aortobi-iliac","description":"Bypass graft, with vein; aortobi-iliac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99282","name":"Emergency dept visit sf mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64643","name":"Chemodenerv 1 extrem 1-4 ea","description":"Chemodenervation of one extremity; each additional extremity, 1-4 muscle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L4380","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99091","name":"Collj & interpj data ea 30 d","description":"Collection and interpretation of physiologic data (eg, ecg, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) r","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11828.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40816","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42509","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with excision of both submandibular glands","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2448.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88155","name":"Cytopath c/v index add-on","description":"Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, maturation index, karyopyknotic index, estrogenic index) (list separately in addition to code[s] for other technical and interpretation services)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29875","name":"Arthrs knee surg synvct lmtd","description":"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6747.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6013","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62258","name":"Replace brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23500","name":"Cltx clavicular fx w/o mnpj","description":"Closed treatment of clavicular fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36471","name":"Njx sclrsnt mlt incmptnt vn","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90828","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82360","name":"Calculus assay quant","description":"Calculus; quantitative analysis, chemical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48548","name":"Fuse pancreas and bowel","description":"Pancreaticojejunostomy, side-to-side anastomosis (puestow-type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84138","name":"Assay of pregnanetriol","description":"Pregnanetriol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29000","name":"Appl halo type body cast","description":"Application of halo type body cast (see 20661-20663 for insertion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64510","name":"N block stellate ganglion","description":"Injection, anesthetic agent; stellate ganglion (cervical sympathetic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33955","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76496","name":"Unlisted fluoroscopic px","description":"Unlisted fluoroscopic procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43191","name":"Esophagoscopy rigid trnso dx","description":"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0431","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11306","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89060","name":"Exam synovial fluid crystals","description":"Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2453.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99492","name":"1st psyc collab care mgmt","description":"Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93511","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S0199","name":"Med abortion inc all ex drug","description":"Medically induced abortion by oral ingestion of medication including all associated services and supplies (e.g., patient counseling, office visits, confirmation of pregnancy by hcg, ultrasound to confirm duration of pregnancy, ultrasound to confirm completion of abortion) except drugs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86901","name":"Blood typing serologic rh(d)","description":"Blood typing, serologic; rh (d)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82486","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94240","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0563T","name":"Evac meibomian glnd heat bi","description":"Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50328","name":"Prep renal graft/arterial","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27826","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64585","name":"Rev/rmv perph nstim eltrd ra","description":"Revision or removal of peripheral neurostimulator electrode array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75995","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0241","name":"Bath tub wall rail","description":"Bath tub wall rail, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83874","name":"Assay of myoglobin","description":"Myoglobin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"49327","name":"Lap ins device for rt","description":"Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (list separately in addition to code for primary proced","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50205","name":"Renal bx surg exposure kdn","description":"Renal biopsy; by surgical exposure of kidney","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36834","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1414.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92326","name":"Replacement of contact lens","description":"Replacement of contact lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4210","name":"Orth dev repair/repl minor p","description":"Repair of orthotic device, repair or replace minor parts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23532","name":"Optx strclv dslc aq/chrn grf","description":"Open treatment of sternoclavicular dislocation, acute or chronic; with fascial graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27048","name":"Exc hip/pelv tum deep < 5 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97605","name":"Neg prs wnd ther dme<=50sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8105.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44322","name":"Colostomy with biopsies","description":"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80158","name":"Drug assay cyclosporine","description":"Cyclosporine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37236","name":"Open/perq place stent 1st","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80174","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0392","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12015","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0180","name":"Md certification hha patient","description":"Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37236","name":"Open/perq place stent 1st","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23155","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74248","name":"X-ray sm int f-thru std","description":"Radiologic small intestine follow-through study, including multiple serial images (list separately in addition to code for primary procedure for upper gi radiologic examination)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46255","name":"Remove int/ext hem 1 group","description":"Hemorrhoidectomy, internal and external, single column/group;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65865","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52500","name":"Trurl resection bladder neck","description":"Transurethral resection of bladder neck (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33430","name":"Replacement of mitral valve","description":"Replacement, mitral valve, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3999","name":"Upper limb orthosis nos","description":"Upper limb orthosis, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L2860","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69745","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52260","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81204","name":"Ar gene charac alleles","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; characterization of alleles (eg, expanded size or methylation status)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33213","name":"Insert pulse gen dual leads","description":"Insertion of pacemaker pulse generator only; with existing dual leads","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22558","name":"Arthrd ant ntrbd min dsc lum","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37193","name":"Rem endovas vena cava filter","description":"Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"13122","name":"Cmplx rpr s/a/l addl 5 cm/>","description":"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23200","name":"Radical rescj tumor clavicle","description":"Radical resection of tumor; clavicle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1605.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33845","name":"Excision coa w/graft","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77525","name":"Proton treatment complex","description":"Proton treatment delivery; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15819","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33249","name":"Insj/rplcmt defib w/lead(s)","description":"Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9984","name":"Remote e/m est. pt  15mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: an expanded problem focused history;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37182","name":"Insert hepatic shunt (tips)","description":"Insertion of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract formation/dilatation, stent placement and all associated imaging guidance and documentation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64402","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31661","name":"Bronch thermoplsty 2/> lobes","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93651","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39503","name":"Repair of diaphragm hernia","description":"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5326.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3455.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26450","name":"Incision of palm tendon","description":"Tenotomy, flexor, palm, open, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27303","name":"Drainage of bone lesion","description":"Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36908","name":"Stent plmt ctr dialysis seg","description":"Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (list separately in addition to","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58140","name":"Myomectomy abdom method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0274T","name":"Prq lamot/lam dcmpr crv/thrc","description":"Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, ct), single or multiple levels, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50433","name":"Plmt nephroureteral catheter","description":"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99402","name":"Prev med cnsl indiv apprx 30","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36578","name":"Replace tunneled cv cath","description":"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27035","name":"Denervation of hip joint","description":"Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of sciatic, femoral, or obturator nerves","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93229","name":"Remote 30 day ecg tech supp","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90802","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88271","name":"Cytogenetics dna probe","description":"Molecular cytogenetics; dna probe, each (eg, fish)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26556","name":"Toe joint transfer","description":"Transfer, free toe joint, with microvascular anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25425","name":"Repair/graft radius or ulna","description":"Repair of defect with autograft; radius or ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33602","name":"Closure of valve","description":"Closure of semilunar valve (aortic or pulmonary) by suture or patch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0212T","name":"Compre audiometry evaluation","description":"Comprehensive audiometry threshold evaluation and speech recognition (0209t, 0211t combined), automated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1686.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87207","name":"Smear special stain","description":"Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0503","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52327","name":"Cystoscopy inject material","description":"Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28290","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15922","name":"Exc coccygl pr ulc flap clsr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33881","name":"Evasc rpr ta ndgft xcov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft not involving coverage of the left subclavian artery origin and all","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1758","name":"Catheter, ureteral","description":"Catheter, ureteral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9141","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33235","name":"Removal pacemaker electrode","description":"Removal of transvenous pacemaker electrode(s); dual lead system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9282","name":"Wig any type","description":"Wig, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35526","name":"Art byp grft aor/carot/innom","description":"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93295","name":"Dev interrog remote 1/2/mlt","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42953","name":"Repair throat esophagus","description":"Pharyngoesophageal repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"Office o/p est sf 10 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 10 minutes must be met o","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27808","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61645","name":"Perq art m-thrombect &/nfs","description":"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44155","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with ileostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26650","name":"Treat thumb fracture","description":"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8170.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71090","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47800","name":"Reconstruction of bile ducts","description":"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9512","name":"Tc99m pertechnetate","description":"Technetium tc-99m pertechnetate, diagnostic, per millicurie","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31580","name":"Laryngoplasty laryngeal web","description":"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67208","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8424","name":"Ready gradient sleeve","description":"Gradient pressure aid (sleeve), ready made","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87632","name":"Resp virus 6-11 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61750","name":"Incise skull/brain biopsy","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61796","name":"Srs cranial lesion simple","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31661","name":"Bronch thermoplsty 2/> lobes","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 2 or more lobes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65272","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44615","name":"Intestinal stricturoplasty","description":"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0202U","name":"Nfct ds 22 trgt sars-cov-2","description":"Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific nucleic acid (dna or rna), 22 targets including severe acute respiratory syndrome coronavirus 2 (sars-cov-2), qualitative rt-pcr, nasopharyngeal swab, each pathogen reported as detected or not detected","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28475","name":"Cltx metatarsal fx w/mnpj ea","description":"Closed treatment of metatarsal fracture; with manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96366","name":"Ther/proph/diag iv inf addon","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1189.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22206","name":"Incis spine 3 column thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2482.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87540","name":"Legion pneumo dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27397","name":"Transplants of thigh tendons","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); multiple tendons","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27485","name":"Surgery to stop leg growth","description":"Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3035.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61626","name":"Tcat perm occls/embol noncns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57267","name":"Insert mesh/pelvic flr addon","description":"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2842.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11423","name":"Exc h-f-nk-sp b9+marg 2.1-3","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49013","name":"Prpertl pel pack hemrrg trma","description":"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36148","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6256","name":"Absorpt drg > 48 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21720","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; without cast application","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93622","name":"Comp ep eval l ventr pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left ventricular pacing and recording (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2150.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58543","name":"Lsh uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28003","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59618","name":"Attempted vbac delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care, following attempted vaginal delivery after previous cesarean delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2108.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0290","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"39402","name":"Mediastinoscpy w/lmph nod bx","description":"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34707","name":"Evasc rpr ilio-iliac ndgft","description":"Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1500.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15050","name":"Pinch graft up to 2 cm diam","description":"Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34833","name":"Opn ilac art expos cndt crtj","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6246.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4458","name":"Reusable enema bag","description":"Enema bag with tubing, reusable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61705","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66630","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93248","name":"Ext ecg>7d<15d rev&interpj","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; review and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43226","name":"Esoph endoscopy dilation","description":"Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6020.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33770","name":"Rpr tga w/o surg enlgmnt vsd","description":"Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular septal defect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25415","name":"Repair radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; without graft (eg, compression technique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75662","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11040","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64625","name":"Rf abltj nrv nrvtg si jt","description":"Radiofrequency ablation, nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96165","name":"Hlth bhv ivntj grp ea addl","description":"Health behavior intervention, group (2 or more patients), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80150","name":"Assay of amikacin","description":"Amikacin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2073.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80434","name":"Insulin tolerance panel","description":"Insulin tolerance panel; for acth insufficiency this panel must include the following: cortisol (82533 x 5) glucose (82947 x 5)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65093","name":"Revise eye with implant","description":"Evisceration of ocular contents; with implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62318","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5349.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67880","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23075","name":"Exc shoulder les sc < 3 cm","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25900","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80076","name":"Hepatic function panel","description":"Hepatic function panel this panel must include the following: albumin (82040) bilirubin, total (82247) bilirubin, direct (82248) phosphatase, alkaline (84075) protein, total (84155) transferase, alanine amino (alt) (sgpt) (84460) transferase, aspartate amino (ast) (sgot) (84450)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33251","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43760","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78586","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35548","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15130","name":"Drm agrft t/a/l 1st 100 sqcm","description":"Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4755","name":"Comb art/venous blood tubing","description":"Blood tubing, arterial and venous combined, for hemodialysis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80154","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37227","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26490","name":"Revise thumb tendon","description":"Opponensplasty; superficialis tendon transfer type, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50320","name":"Remove kidney living donor","description":"Donor nephrectomy (including cold preservation); open, from living donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66988","name":"Xcapsl ctrc rmvl w/ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with endoscopic cyclophotocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5233.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15200","name":"Fth/gft fr trnk 20 sq cm/<","description":"Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3503.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35623","name":"Bpg axillary-pop/-tibial","description":"Bypass graft, with other than vein; axillary-popliteal or -tibial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47525","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99447","name":"Ntrprof ph1/ntrnet/ehr 11-20","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36473","name":"Endovenous mchnchem 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86316","name":"Immunoassay tumor other","description":"Immunoassay for tumor antigen, other antigen, quantitative (eg, ca 50, 72-4, 549), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94003","name":"Vent mgmt inpat subq day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, each subsequent day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35665","name":"Bpg iliofemoral","description":"Bypass graft, with other than vein; iliofemoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48105","name":"Resect/debride pancreas","description":"Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61864","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92975","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61564","name":"Excision of skull tumor","description":"Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2208.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27538","name":"Treat knee fracture(s)","description":"Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, with or without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1571.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43645","name":"Lap gastr bypass incl smll i","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96138","name":"Psycl/nrpsyc tech 1st","description":"Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13374.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33050","name":"Resect heart sac lesion","description":"Resection of pericardial cyst or tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33952","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46262","name":"Remove in/ex hem grps w/fist","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75680","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75994","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0313","name":"Immunize couns < 21yr 6-30 m","description":"Immunization counseling by a physician or other qualified health care professional when  the vaccine(s) is not administered on the same date of service for ages under 21, 16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43336","name":"Thorabd diaphr hern repair","description":"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42205","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51795","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83008","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82042","name":"Other source albumin quan ea","description":"Albumin; other source, quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0023","name":"Pin service 60m per month","description":"Principal illness navigation services by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a patient navigator; 60 minutes per calendar month, in the following activities:  person-centered assessment, performed to better understand the indiv","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6208","name":"Contact layer > 48 sq in","description":"Contact layer, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0473","name":"Group behave couns 2-10","description":"Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23930","name":"I&d upr a/e dp absc/hmtma","description":"Incision and drainage, upper arm or elbow area; deep abscess or hematoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25505","name":"Cltx rdl shft fx w/mnpj","description":"Closed treatment of radial shaft fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31288","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87480","name":"Candida dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49656","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50606","name":"Endoluminal bx urtr rnl plvs","description":"Endoluminal biopsy of ureter and/or renal pelvis, non-endoscopic, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50545","name":"Laparo radical nephrectomy","description":"Laparoscopy, surgical; radical nephrectomy (includes removal of gerotas fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37718","name":"Lig div&strpg short saph vn","description":"Ligation, division, and stripping, short saphenous vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28525","name":"Treat toe fracture","description":"Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1734.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35685","name":"Bypass graft patency/patch","description":"Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31526","name":"Dx laryngoscopy w/oper scope","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43268","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86704","name":"Hep b core antibody total","description":"Hepatitis b core antibody (hbcab); total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45392","name":"Colonoscopy w/endoscopic fnb","description":"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64823","name":"Sympathectomy supfc palmar","description":"Sympathectomy; superficial palmar arch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81178","name":"Atxn1 gene detc abnor allele","description":"Atxn1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42182","name":"Repair palate","description":"Repair, laceration of palate; over 2 cm or complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89105","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21365","name":"Opn tx complx malar fx","description":"Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15150","name":"Tis cltr skn agrft t/a/l 1st","description":"Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62319","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84156","name":"Assay of protein urine","description":"Protein, total, except by refractometry; urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67318","name":"Revise eye muscle(s)","description":"Strabismus surgery, any procedure, superior oblique muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25607","name":"Optx dst rd xartc fx/epi sep","description":"Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32550","name":"Insert pleural cath","description":"Insertion of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30320","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; by lateral rhinotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50593","name":"Perc cryo ablate renal tum","description":"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33870","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4550","name":"Surgical trays","description":"Surgical trays","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86200","name":"Ccp antibody","description":"Cyclic citrullinated peptide (ccp), antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87209","name":"Smear complex stain","description":"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63085","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27769","name":"Optx post ankle fx","description":"Open treatment of posterior malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59120","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84228","name":"Assay of quinine","description":"Quinine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99343","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23145","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15782","name":"Dermabrasion other than face","description":"Dermabrasion; regional, other than face","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50575","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46910","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22525","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3567.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63685","name":"Ins/rplc spi npg/rcvr pocket","description":"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87260","name":"Adenovirus ag if","description":"Infectious agent antigen detection by immunofluorescent technique; adenovirus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"24220","name":"Injection px for elbow arthg","description":"Injection procedure for elbow arthrography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99421","name":"Ol dig e/m svc 5-10 min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63273","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78478","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4305","name":"Drug delivery system >=50 ml","description":"Disposable drug delivery system, flow rate of 50 ml or greater per hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44397","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35623","name":"Bpg axillary-pop/-tibial","description":"Bypass graft, with other than vein; axillary-popliteal or -tibial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28470","name":"Cltx metatarsal fx wo mnp ea","description":"Closed treatment of metatarsal fracture; without manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35585","name":"Vein byp fem-tibial peroneal","description":"In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54512","name":"Excise lesion testis","description":"Excision of extraparenchymal lesion of testis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87147","name":"Culture type immunologic","description":"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86632","name":"Chlamydia igm antibody","description":"Antibody; chlamydia, igm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21270","name":"Augmentation cheek bone","description":"Malar augmentation, prosthetic material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67225","name":"Eye photodynamic ther add-on","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (list separately in addition to code for primary eye treatment)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27846","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43249","name":"Esoph egd dilation <30 mm","description":"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"68811","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22010","name":"I&d p-spine c/t/cerv-thor","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92977","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99408","name":"Audit/dast 15-30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; 15 to 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27468","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69725","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; including medial to geniculate ganglion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21432","name":"Optx cranfcl sep w/wiring","description":"Open treatment of craniofacial separation (lefort iii type); with wiring and/or internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42420","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25116","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30220","name":"Insert nasal septal button","description":"Insertion, nasal septal prosthesis (button)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20661","name":"Application halo cranial","description":"Application of halo, including removal; cranial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62164","name":"Remove brain tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of brain tumor, including placement of external ventricular catheter for drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"19020","name":"Mastotomy expl drg absc dp","description":"Mastotomy with exploration or drainage of abscess, deep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3997.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32605","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00400","name":"Anes integumentary sys nos","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27637","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25295","name":"Release wrist/forearm tendon","description":"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87641","name":"Mr-staph dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); staphylococcus aureus, methicillin resistant, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31525","name":"Dx laryngoscopy excl nb","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99490","name":"Chrnc care mgmt staff 1st 20","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27881","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15170","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43324","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46611","name":"Anoscopy","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25337","name":"Reconstruct ulna/radioulnar","description":"Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11470","name":"Exc skn h/p/p/u smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50980","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50234","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through same incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30801","name":"Ablate inf turbinate superf","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36578","name":"Replace tunneled cv cath","description":"Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92998","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15769","name":"Grfg autol soft tiss dir exc","description":"Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11951","name":"Subq njx fil matrl 1.1-5.0cc","description":"Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67400","name":"Explore/biopsy eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35645","name":"Bpg subclavian-vertebral","description":"Bypass graft, with other than vein; subclavian-vertebral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99498","name":"Advncd care plan addl 30 min","description":"Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; each additional 30 minutes (list separately in addition to code for primary proce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83026","name":"Hemoglobin copper sulfate","description":"Hemoglobin; by copper sulfate method, non-automated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66710","name":"Ciliary transsleral therapy","description":"Ciliary body destruction; cyclophotocoagulation, transscleral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64600","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64857","name":"Repair arm/leg nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33924","name":"Remove pulmonary shunt","description":"Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15731","name":"Forehead flap w/vasc pedicle","description":"Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95028","name":"Iq tsts allergy delayed rxn","description":"Intracutaneous (intradermal) tests with allergenic extracts, delayed type reaction, including reading, specify number of tests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8908","name":"Mri w/o fol w/cont, breast,","description":"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4543","name":"Adult disp brief/diap abv xl","description":"Adult sized disposable incontinence product, protective brief/diaper, above extra large, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67210","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; photocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86386","name":"Nuclear matrix protein 22","description":"Nuclear matrix protein 22 (nmp22), qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44126","name":"Enterectomy w/o taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99050","name":"Medical services after hrs","description":"Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (eg, holidays, saturday or sunday), in addition to basic service","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46604","name":"Anoscopy and dilation","description":"Anoscopy; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52345","name":"Cysto/uretero w/up stricture","description":"Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67930","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; partial thickness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11644","name":"Exc f/e/e/n/l mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44210","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88374","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32442","name":"Sleeve pneumonectomy","description":"Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15004","name":"Wound prep f/n/hf/g","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of bo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57307","name":"Fistula repair & colostomy","description":"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87274","name":"Herpes simplex 1 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80440","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1582.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33969","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99439","name":"Chrnc care mgmt staf ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32095","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32940","name":"Revision of lung","description":"Pneumonolysis, extraperiosteal, including filling or packing procedures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26210","name":"Removal of finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23130","name":"Acromp/acromionectomy prtl","description":"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43257","name":"Egd w/thrml txmnt gerd","description":"Esophagogastroduodenoscopy, flexible, transoral; with delivery of thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61797","name":"Srs cran les simple addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31637","name":"Bronchoscopy stent add-on","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; each additional major bronchus stented (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43267","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58900","name":"Biopsy of ovary(s)","description":"Biopsy of ovary, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13120","name":"Cmplx rpr s/a/l 1.1-2.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34813","name":"Femoral endovas graft add-on","description":"Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22857","name":"Tot disc arthrp 1ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84206","name":"Assay of proinsulin","description":"Proinsulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54438","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3212","name":"Benesch boot pair infant","description":"Benesch boot, pair, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L2770","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58970","name":"Retrieval of oocyte","description":"Follicle puncture for oocyte retrieval, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13827.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0415","name":"Open tx post pelvic fxcture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33955","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17313","name":"Mohs 1 stage t/a/l","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), o","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24495","name":"Decompression fasct forearm","description":"Decompression fasciotomy, forearm, with brachial artery exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44180","name":"Lap enterolysis","description":"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7523.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4580","name":"Cast supplies (plaster)","description":"Cast supplies (e.g., plaster)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93564","name":"Njx cgen car cath slctv opac","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aortocoronary saphenous vein, free radial artery, or free mammary artery graft) to one or more coronary a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50551","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21246","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44660","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; without intestinal or bladder resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87328","name":"Cryptosporidium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptosporidium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28060","name":"Partial removal foot fascia","description":"Fasciectomy, plantar fascia; partial (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37242","name":"Vasc embolize/occlude artery","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malfo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28100","name":"Removal of ankle/heel lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25624","name":"Cltx carpl scphd fx w/mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27712","name":"Osteot mlt relignmt imed rod","description":"Osteotomy; multiple, with realignment on intramedullary rod (eg, sofield type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61584","name":"Orbitocranial approach/skull","description":"Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11732","name":"Avlsn nail plate simple each","description":"Avulsion of nail plate, partial or complete, simple; each additional nail plate (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27447","name":"Total knee arthroplasty","description":"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31546","name":"Remove vc lesion scope/graft","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57296","name":"Revise vag graft open abd","description":"Revision (including removal) of prosthetic vaginal graft; open abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15002","name":"Wound prep trk/arm/leg","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36160","name":"Establish access to aorta","description":"Introduction of needle or intracatheter, aortic, translumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41512","name":"Tongue suspension","description":"Tongue base suspension, permanent suture technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23680","name":"Optx sho dislc neck fx fixj","description":"Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5167.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96922","name":"Excimer lsr psriasis>500sqcm","description":"Excimer laser treatment for psoriasis; over 500 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46916","name":"Cryosurgery anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0392","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87521","name":"Hepatitis c probe&rvrs trnsc","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93981","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61556","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; frontal or parietal bone flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19295","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26715","name":"Treat knuckle dislocation","description":"Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86309","name":"Heterophile antibody titer","description":"Heterophile antibodies; titer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81236","name":"Ezh2 gene full gene sequence","description":"Ezh2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, myelodysplastic syndrome, myeloproliferative neoplasms) gene analysis, full gene sequence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52325","name":"Cystoscopy stone removal","description":"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43762","name":"Rplc gtube no revj trc","description":"Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"39503","name":"Repair of diaphragm hernia","description":"Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36160","name":"Establish access to aorta","description":"Introduction of needle or intracatheter, aortic, translumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33988","name":"Insertion of left heart vent","description":"Insertion of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58823","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26410","name":"Repair hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34803","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0314","name":"Counsel immune <21 16-30 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86789","name":"West nile virus antibody","description":"Antibody; west nile virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31648","name":"Bronchial valve remov init","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15331","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01716","name":"Anes nrv msc upr a&e tndsis","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50650","name":"Removal of ureter","description":"Ureterectomy, with bladder cuff (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5020.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64910","name":"Nerve repair w/allograft","description":"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33340","name":"Perq clsr tcat l atr apndge","description":"Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25280","name":"Revise wrist/forearm tendon","description":"Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82272","name":"Occult bld feces 1-3 tests","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24305","name":"Tendon lngth upr a/e ea tdn","description":"Tendon lengthening, upper arm or elbow, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25825","name":"Arthrd wrist with autograft","description":"Arthrodesis, wrist; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46761","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (park posterior anal repair)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5717.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33702","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34808","name":"Endovas iliac a device addon","description":"Endovascular placement of iliac artery occlusion device (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99304","name":"1st nf care sf/low mdm 25","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selection, 25 minutes mus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97165","name":"Ot eval low complex 30 min","description":"Occupational therapy evaluation, low complexity, requiring these components: an occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; an assessment(s) that identifies 1-3 performance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6024","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4176","name":"Parenteral sol amino acid 7-","description":"Parenteral nutrition solution; amino acid, 7% through 8.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45120","name":"Removal of rectum","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, swenson, duhamel, or soave type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90885","name":"Psy evaluation of records","description":"Psychiatric evaluation of hospital records, other psychiatric reports, psychometric and/or projective tests, and other accumulated data for medical diagnostic purposes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8499","name":"Unlisted misc prosthetic ser","description":"Unlisted procedure for miscellaneous prosthetic services","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89331","name":"Retrograde ejaculation anal","description":"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27635","name":"Remove lower leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15277","name":"Skn sub grft f/n/hf/g child","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0246","name":"Transfer tub rail attachment","description":"Transfer tub rail attachment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87557","name":"M.tuberculo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96004","name":"Phys review of motion tests","description":"Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with writ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83698","name":"Assay lipoprotein pla2","description":"Lipoprotein-associated phospholipase a2 (lp-pla2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39421.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3819","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49324","name":"Lap insert tunnel ip cath","description":"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77520","name":"Proton trmt simple w/o comp","description":"Proton treatment delivery; simple, without compensation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15131","name":"Drm agrft t/a/l ea addl","description":"Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95976","name":"Alys smpl cn npgt prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97168","name":"Ot re-eval est plan care","description":"Re-evaluation of occupational therapy established plan of care, requiring these components: an assessment of changes in patient functional or medical status with revised plan of care; an update to the initial occupational profile to reflect changes in condition or environment that affect future inte","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0005","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; group counseling by a clinician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60502","name":"Re-explore parathyroids","description":"Parathyroidectomy or exploration of parathyroid(s); re-exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0464","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92355","name":"Fitg spect lw vis cmpnd lens","description":"Fitting of spectacle mounted low vision aid; telescopic or other compound lens system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42330","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1627.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27502","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86828","name":"Hla class i&ii antibody qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to hla class i and class ii hla antigens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4721","name":"Dialysat sol fld vol > 999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60254","name":"Extensive thyroid surgery","description":"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21345","name":"Closed tx nose/jaw fx","description":"Closed treatment of nasomaxillary complex fracture (lefort ii type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22901","name":"Exc abdl tum deep 5 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45400","name":"Laparoscopic proc","description":"Laparoscopy, surgical; proctopexy (for prolapse)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84110","name":"Assay of porphobilinogen","description":"Porphobilinogen, urine; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42894","name":"Revision of pharyngeal walls","description":"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80185","name":"Assay of phenytoin total","description":"Phenytoin; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63045","name":"Lam facetec & foramot crv","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64837","name":"Repair nerve add-on","description":"Suture of each additional nerve, hand or foot (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27822","name":"Treatment of ankle fracture","description":"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33275","name":"Tcat rmvl perm ldls pm w/img","description":"Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19290","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92970","name":"Cardioassist internal","description":"Cardioassist-method of circulatory assist; internal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24470","name":"Hemiepiphyseal arrest","description":"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60281","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus; recurrent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42509","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with excision of both submandibular glands","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62351","name":"Implant spinal canal cath","description":"Implantation, revision or repositioning of tunneled intrathecal or epidural catheter, for long-term medication administration via an external pump or implantable reservoir/infusion pump; with laminectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27511","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0174T","name":"Cad cxr with interp","description":"Computer-aided detection (cad) (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation and report, with or without digitization of film radiographic images, chest radiograph(s), performed concurrent with primary interpretation (list s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7523","name":"Tracheostomy shower protect","description":"Tracheostomy shower protector, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14747.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36481","name":"Insertion of catheter vein","description":"Percutaneous portal vein catheterization by any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49651","name":"Lap ing hernia repair recur","description":"Laparoscopy, surgical; repair recurrent inguinal hernia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21270","name":"Augmentation cheek bone","description":"Malar augmentation, prosthetic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0434","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3798.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57061","name":"Destruction vag lesions smpl","description":"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50385","name":"Change stent via transureth","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82777","name":"Galectin-3","description":"Galectin-3","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0435","name":"Oral hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8220.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59852","name":"Induced abortion 1+njx hyst","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99177","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43198","name":"Esophagosc flex trnsn biopsy","description":"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9276","name":"Disposable sensor, cgm sys","description":"Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31531","name":"Laryngoscopy w/fb & op scope","description":"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33891","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27618","name":"Exc leg/ankle tum < 3 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11001","name":"Dbrdmt ecz/infct skn ea addl","description":"Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95975","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24065","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24201","name":"Rmvl fb upper arm/elbw deep","description":"Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87187","name":"Sc std microdil/agar mlc","description":"Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (mlc), each plate (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5441.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84378","name":"Sugars single quant","description":"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27006","name":"Tenotomy abductor&/xtnsr hip","description":"Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93237","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0353T","name":"Intraop oct breast cavity","description":"Optical coherence tomography of breast, surgical cavity; real-time intraoperative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50060","name":"Nl removal calculus","description":"Nephrolithotomy; removal of calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34803","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85306","name":"Clot inhibit prot s free","description":"Clotting inhibitors or anticoagulants; protein s, free","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8688","name":"Implt nrostm pls gen dua non","description":"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19296","name":"Place po breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; on date separate from partial mastectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43229","name":"Esophagoscopy lesion ablate","description":"Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0146","name":"Nav srv peer sup add 30 pr m","description":"Principal illness navigation - peer support, additional 30 minutes per calendar month (list separately in addition to g0140)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58542","name":"Lsh w/t/o ut 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86880","name":"Coombs test direct","description":"Antihuman globulin test (coombs test); direct, each antiserum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22554","name":"Arthrd ant ntrbd min dsc crv","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below c2","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80074","name":"Acute hepatitis panel","description":"Acute hepatitis panel this panel must include the following: hepatitis a antibody (haab), igm antibody (86709) hepatitis b core antibody (hbcab), igm antibody (86705) hepatitis b surface antigen (hbsag) (87340) hepatitis c antibody (86803)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63265","name":"Excise intraspinl lesion crv","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61583","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56820","name":"Colposcopy vulva","description":"Colposcopy of the vulva;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50810","name":"Fusion of ureter & bowel","description":"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15272","name":"Skin sub graft t/a/l add-on","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61870","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21385","name":"Opn tx orbit fx transantral","description":"Open treatment of orbital floor blowout fracture; transantral approach (caldwell-luc type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23350","name":"Injection for shoulder x-ray","description":"Injection procedure for shoulder arthrography or enhanced ct/mri shoulder arthrography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57105","name":"Biopsy vaginal mucosa xtnsv","description":"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6022","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43285","name":"Rmvl esophgl sphnctr dev","description":"Removal of esophageal sphincter augmentation device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2244.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0507T","name":"Near ifr 2img mibmn glnd i&r","description":"Near infrared dual imaging (ie, simultaneous reflective and transilluminated light) of meibomian glands, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45321","name":"Proctosigmoidoscopy volvul","description":"Proctosigmoidoscopy, rigid; with decompression of volvulus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1751","name":"Cath, inf, per/cent/midline","description":"Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20937","name":"Sp bone agrft morsel add-on","description":"Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54065","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36251","name":"Ins cath ren art 1st unilat","description":"Selective catheter placement (first-order), main renal artery and any accessory renal artery(s) for renal angiography, including arterial puncture and catheter placement(s), fluoroscopy, contrast injection(s), image postprocessing, permanent recording of images, and radiological supervision and inte","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22552","name":"Arthrd ant ntrbd cervical ea","description":"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below c2, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43754","name":"Dx gastr intub w/asp spec","description":"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31238","name":"Nsl/sins ndsc srg nsl hemrrg","description":"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35700","name":"Reoperation bypass graft","description":"Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32200","name":"Drain open lung lesion","description":"Pneumonostomy, with open drainage of abscess or cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28605","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"S0610","name":"Annual gynecological examina","description":"Annual gynecological examination, new patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21602","name":"Exc ch wal tum w/o lymphadec","description":"Excision of chest wall tumor involving rib(s), with plastic reconstruction; without mediastinal lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64495","name":"Inj paravert f jnt l/s 3 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; third and any additional level(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51595","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61334","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66170","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81233","name":"Btk gene common variants","description":"Btk (brutons tyrosine kinase) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, c481s, c481r, c481f)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82340","name":"Assay of calcium in urine","description":"Calcium; urine quantitative, timed specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54690","name":"Laparoscopy orchiectomy","description":"Laparoscopy, surgical; orchiectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92650","name":"Aep scr auditory potential","description":"Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95970","name":"Alys npgt w/o prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33221","name":"Insert pulse gen mult leads","description":"Insertion of pacemaker pulse generator only; with existing multiple leads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15335","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45119","name":"Remove rectum w/reservoir","description":"Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66821","name":"After cataract laser surgery","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, yag laser) (1 or more stages)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20700","name":"Mnl prep&insj dp rx dlvr dev","description":"Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3219","name":"Orthopedic mens shoes oxford","description":"Orthopedic footwear, mens shoe, oxford, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0144","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4911","name":"Drain bag/bottle","description":"Drain bag/bottle, for dialysis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1775.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21346","name":"Opn tx nasomax fx w/fixj","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with wiring and/or local fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94013","name":"Meas lung vol thru 2 yrs","description":"Measurement of lung volumes (ie, functional residual capacity [frc], forced vital capacity [fvc], and expiratory reserve volume [erv]) in an infant or child through 2 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83013","name":"H pylori (c-13) breath","description":"Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31293","name":"Nsl/sins ndsc med&inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37215","name":"Transcath stent cca w/eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27385","name":"Repair of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; primary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4028","name":"Cast sup hip spica ped fbrgl","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14621.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33262","name":"Rmvl& replc pulse gen 1 lead","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; single lead system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36500","name":"Insertion of catheter vein","description":"Venous catheterization for selective organ blood sampling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80307","name":"Drug test prsmv chem anlyzr","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; by instrument chemistry analyzers (eg, utilizing immunoassay [eg, eia, elisa, emit, fpia, ia, kims, ria]), chromatography (eg, gc, hplc), and mass spectrometry either with or without chromatography, (eg, dart","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87590","name":"N.gonorrhoeae dna dir prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5330.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33120","name":"Exc icar tum resc w/card byp","description":"Excision of intracardiac tumor, resection with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43235","name":"Egd diagnostic brush wash","description":"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9982.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6017","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0207T","name":"Clear eyelid gland w/heat","description":"Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35472","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26075","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19330","name":"Rmvl ruptured breast implant","description":"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24340","name":"Tenodesis biceps tdn at elbw","description":"Tenodesis of biceps tendon at elbow (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86304","name":"Immunoassay tumor ca 125","description":"Immunoassay for tumor antigen, quantitative; ca 125","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2028.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4268","name":"Female condom","description":"Contraceptive supply, condom, female, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31611","name":"Constj trachesophgl fstl","description":"Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, blom-singer prosthesis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34812","name":"Opn fem art expos","description":"Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27269","name":"Optx thigh fx","description":"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43271","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27252","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92606","name":"Non-speech device service","description":"Therapeutic service(s) for the use of non-speech-generating device, including programming and modification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9187","name":"Bpci home visit","description":"Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/managemen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95018","name":"All tstg perq&iq drugs/biol","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87556","name":"M.tuberculo dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92358","name":"Aphakia prosth service temp","description":"Prosthesis service for aphakia, temporary (disposable or loan, including materials)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50800","name":"Implant ureter in bowel","description":"Ureteroenterostomy, direct anastomosis of ureter to intestine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37760","name":"Lig prfratr vn radical 1 leg","description":"Ligation of perforator veins, subfascial, radical (linton type), including skin graft, when performed, open,1 leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92941","name":"Prq trlml revsc tot occl ami","description":"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single major coronary artery and/or its branches or single bypass g","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30420","name":"Reconstruction of nose","description":"Rhinoplasty, primary; including major septal repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17280","name":"Dstr mal ls f/e/e/n/l/m .5/<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95707","name":"Eeg w/o vid 2-12hr cont mntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4197","name":"Parenteral sol 74-100 gm pro","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22318","name":"Treat odontoid fx w/o graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62380","name":"Ndsc dcmprn 1 ntrspc lumbar","description":"Endoscopic decompression of spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8925.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19304","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87149","name":"Dna/rna direct probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, direct probe technique, per culture or isolate, each organism probed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3095.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81305","name":"Myd88 gene p.leu265pro vrnt","description":"Myd88 (myeloid differentiation primary response 88) (eg, waldenstroms macroglobulinemia, lymphoplasmacytic leukemia) gene analysis, p.leu265pro (l265p) variant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93750","name":"Interrogation vad in person","description":"Interrogation of ventricular assist device (vad), in person, with physician or other qualified health care professional analysis of device parameters (eg, drivelines, alarms, power surges), review of device function (eg, flow and volume status, septum status, recovery), with programming, if performe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1726.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92653","name":"Aep neurodiagnostic i&r","description":"Auditory evoked potentials; neurodiagnostic, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21552","name":"Exc neck les sc 3 cm/>","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96001","name":"Motion test w/ft press meas","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics; with dynamic plantar pressure measurements during walking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86713","name":"Legionella antibody","description":"Antibody; legionella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3798.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46610","name":"Anoscopy remove lesion","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G2006","name":"Post-d/c h vst ext pt 20 m","description":"Brief (20 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facili","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22856","name":"Tot disc arthrp 1ntrspc crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0432","name":"Eia hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36226","name":"Place cath vertebral art","description":"Selective catheter placement, vertebral artery, unilateral, with angiography of the ipsilateral vertebral circulation and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63275","name":"Bx/exc xdrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3255","name":"Orth foot non-standard size/","description":"Non-standard size or length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23073","name":"Exc shoulder tum deep 5 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38747","name":"Remove abdominal lymph nodes","description":"Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11975","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24145","name":"Prtl exc bone radial h/n","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), radial head or neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12001","name":"Rpr s/n/ax/gen/trnk 2.5cm/<","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35694","name":"Art trnsposj subclav carotid","description":"Transposition and/or reimplantation; subclavian to carotid artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4159","name":"Ef ped complete soy based","description":"Enteral formula, for pediatrics, nutritionally complete soy based with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82649","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20926","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27830","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21139","name":"Rdctj forehead cntrg&setback","description":"Reduction forehead; contouring and setback of anterior frontal sinus wall","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58541","name":"Lsh uterus 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G2001","name":"Post d/c h vst new pt 20 m","description":"Brief (20 minutes) in-home visit for a new patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0245","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26916.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8428","name":"Ready gradient gauntlet","description":"Gradient pressure aid (gauntlet), ready made","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36013","name":"Place catheter in artery","description":"Introduction of catheter, right heart or main pulmonary artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1735.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2248.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62282","name":"Treat spinal canal lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, lumbar, sacral (caudal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92941","name":"Prq trlml revsc tot occl ami","description":"Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single major coronary artery and/or its branches or single bypass g","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"14061","name":"Tis trnfr e/n/e/l10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37213","name":"Thromblytic art/ven therapy","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92997","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49656","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92615","name":"Laryngoscopic sensory i&r","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2096.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2092.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26479","name":"Shortening of hand tendon","description":"Shortening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35266","name":"Rpr blvsl grf oth/th vn uxtr","description":"Repair blood vessel with graft other than vein; upper extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80424","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for pheochromocytoma this panel must include the following: catecholamines, fractionated (82384 x 2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28272","name":"Release of toe joint each","description":"Capsulotomy; interphalangeal joint, each joint (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25078","name":"Resect forarm/wrist tum 3cm>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46611","name":"Anoscopy","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99363","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26025","name":"Drainage of palm bursa","description":"Drainage of palmar bursa; single, bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99254","name":"Ip/obs cnsltj new/est mod 60","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63707","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33997","name":"Rmvl perq right heart vad","description":"Removal of percutaneous right heart ventricular assist device, venous cannula, at separate and distinct session from insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32557","name":"Insert cath pleura w/ image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43845","name":"Gastroplasty duodenal switch","description":"Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77412","name":"Radiation tx delivery lvl 3","description":"Radiation treatment delivery; level 3, multiple isocenters with photon therapy (eg, 2d, 3d, or imrt) or a single-isocenter photon therapy (eg, 3d or imrt) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87279","name":"Parainfluenza ag if","description":"Infectious agent antigen detection by immunofluorescent technique; parainfluenza virus, each type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1606.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15361","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AV","AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95165","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of doses)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6218","name":"Non-sterile gauze > 48 sq in","description":"Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9983","name":"Remote e/m est. pt 10mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires at least 2 of the following 3 key components: a problem focused history; a problem","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86833","name":"Hla class ii high defin qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); high definition qualitative panel for identification of antibody specificities (eg, individual antigen per bead methodology), hla class ii","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3320","name":"Shoe lift elev heel/sole cor","description":"Lift, elevation, heel and sole, cork, per inch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29705","name":"Rmvl/bivlv full arm/leg cast","description":"Removal or bivalving; full arm or full leg cast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27324","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27687","name":"Revision of calf tendon","description":"Gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54340","name":"Rpr hypspad comp simple","description":"Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86340","name":"Intrinsic factor antibody","description":"Intrinsic factor antibodies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87556","name":"M.tuberculo dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24343","name":"Repr elbow lat ligmnt w/tiss","description":"Repair lateral collateral ligament, elbow, with local tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5454.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90829","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90807","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36002","name":"Pseudoaneurysm injection trt","description":"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2009","name":"Post-d/c h vst ext pt 60 m","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatien","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64712","name":"Revision of sciatic nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"80402","name":"Acth stimulation panel","description":"Acth stimulation panel; for 21 hydroxylase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxyprogesterone (83498 x 2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44377","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65260","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, magnetic extraction, anterior or posterior route","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28490","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43198","name":"Esophagosc flex trnsn biopsy","description":"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42300","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36595","name":"Mech remov tunneled cv cath","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63740","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88263","name":"Chromosome analysis 45","description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93245","name":"Ext ecg>7d<15d rec scan a/r","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44055","name":"Correct malrotation of bowel","description":"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, ladd procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35638","name":"Bpg aortobi-iliac","description":"Bypass graft, with other than vein; aortobi-iliac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30600","name":"Repair mouth/nose fistula","description":"Repair fistula; oronasal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21348","name":"Opn tx nasomax fx w/graft","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); with bone grafting (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87427","name":"Shiga-like toxin ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; shiga-like toxin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21602","name":"Exc ch wal tum w/o lymphadec","description":"Excision of chest wall tumor involving rib(s), with plastic reconstruction; without mediastinal lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01620","name":"Anes clsd px shoulder joint","description":"Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77525","name":"Proton treatment complex","description":"Proton treatment delivery; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90865","name":"Narcosynthesis","description":"Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (amytal) interview)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69150","name":"Extensive ear canal surgery","description":"Radical excision external auditory canal lesion; without neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21154","name":"Rcnstj mdfc lefort iii w/o i","description":"Reconstruction midface, lefort iii (extracranial), any type, requiring bone grafts (includes obtaining autografts); without lefort i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49405","name":"Image cath fluid colxn visc","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45990","name":"Surg dx exam anorectal","description":"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63087","name":"Remov vertbr dcmprn thrclmbr","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42892","name":"Revision of pharyngeal walls","description":"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0071A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4841.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4211","name":"Supp for self-adm injections","description":"Supplies for self-administered injections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22812","name":"Arthrd ant dfrm 8+ vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33511","name":"Cabg vein two","description":"Coronary artery bypass, vein only; 2 coronary venous grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35132","name":"Repair artery rupture groin","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery (common, hypogastric, external)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82489","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47144","name":"Prep donor liver 3-segment","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegmen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33255","name":"Ablate atria w/o bypass ext","description":"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33820","name":"Repair pda by ligation","description":"Repair of patent ductus arteriosus; by ligation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99091","name":"Collj & interpj data ea 30 d","description":"Collection and interpretation of physiologic data (eg, ecg, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) r","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27235","name":"Treat thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, proximal end, neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27500","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2291","name":"Planar back for ped size wc","description":"Back, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31300","name":"Removal of larynx lesion","description":"Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93621","name":"Comp ep evl l pac&rec c sins","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with left atrial pacing and recording from coronary sinus or left atrium (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35011","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, axillary-brachial artery, by arm incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92518","name":"Vemp test i&r ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; ocular (ovemp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53854","name":"Trurl dstrj prst8 tiss rf wv","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80100","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35005","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01850","name":"Anes vein f/arm wrst&hnd nos","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50436","name":"Dilat xst trc ndurlgc px","description":"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36555","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15944","name":"Exc isch pr ulc skn flp clsr","description":"Excision, ischial pressure ulcer, with skin flap closure;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63173","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31651","name":"Bronchial valve addl insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86891","name":"Autologous blood op salvage","description":"Autologous blood or component, collection processing and storage; intra- or postoperative salvage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87903","name":"Phenotype dna hiv w/culture","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; first through 10 drugs tested","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0694","name":"Uvl md cabinet sys 6 ft","description":"Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80055","name":"Obstetric panel","description":"Obstetric panel this panel must include the following: blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85007 or 85009) hepatitis b surface antigen (","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99238","name":"Hosp ip/obs dschrg mgmt 30/<","description":"Hospital inpatient or observation discharge day management; 30 minutes or less on the date of the encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15271","name":"Skin sub graft trnk/arm/leg","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24134","name":"Sequestrectomy shft/dstl hum","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61450","name":"Crnec stpl sctj cmprn/dcmprn","description":"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96130","name":"Psycl tst eval phys/qhp 1st","description":"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19361","name":"Brst rcnstj latsms drsi flap","description":"Breast reconstruction; with latissimus dorsi flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26650","name":"Treat thumb fracture","description":"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29868","name":"Meniscal trnspl knee w/scpe","description":"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29848","name":"Wrist endoscopy/surgery","description":"Endoscopy, wrist, surgical, with release of transverse carpal ligament","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50391","name":"Instll rx agnt into rnal tub","description":"Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25125","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68371","name":"Harvest eye tissue alograft","description":"Harvesting conjunctival allograft, living donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61333","name":"Expl orbit w/removal lesion","description":"Exploration of orbit (transcranial approach), with removal of lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80306","name":"Drug test prsmv instrmnt","description":"Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33961","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22846","name":"Insert spine fixation device","description":"Anterior instrumentation; 4 to 7 vertebral segments (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33859","name":"As-aort grf f/ds oth/thn dsj","description":"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic disease other than dissection (eg, aneurysm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75995","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27394","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, 1 leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1825","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22524","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15221","name":"Fth/gft fr s/a/l each addl","description":"Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87073","name":"Culture bacteria anaerobic","description":"Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99473","name":"Self-meas bp pt educaj/train","description":"Self-measured blood pressure using a device validated for clinical accuracy; patient education/training and device calibration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2301","name":"Pwr standing","description":"Wheelchair accessory, power standing system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50327","name":"Prep renal graft/venous","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33512","name":"Cabg vein three","description":"Coronary artery bypass, vein only; 3 coronary venous grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27256","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2803.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65280","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92100","name":"Serial tonometry","description":"Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (eg, diurnal curve or medical treatment of acute elevation of intraocular pressure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22315","name":"Closed tx vert fx w/manj","description":"Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15341","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34830","name":"Open aortic tube prosth repr","description":"Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; tube prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28306","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27690","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4524.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62142","name":"Rmvl b1 flp/prostc plate skl","description":"Removal of bone flap or prosthetic plate of skull","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"Esrd srv 2-3 vsts p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per m","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25274","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4489.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82190","name":"Atomic absorption","description":"Atomic absorption spectroscopy, each analyte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31238","name":"Nsl/sins ndsc srg nsl hemrrg","description":"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["AW","GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11421","name":"Exc h-f-nk-sp b9+marg 0.6-1","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86729","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45342","name":"Sigmoidoscopy w/us guide bx","description":"Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87802","name":"Strep b assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group b","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57023","name":"I&d vaginal hematoma non-ob","description":"Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92607","name":"Ex for speech device rx 1hr","description":"Evaluation for prescription for speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27324","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95923","name":"Autonomic nrv syst funj test","description":"Testing of autonomic nervous system function; sudomotor, including 1 or more of the following: quantitative sudomotor axon reflex test (qsart), silastic sweat imprint, thermoregulatory sweat test, and changes in sympathetic skin potential","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92601","name":"Cochlear implt f/up exam <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; with programming","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63250","name":"Revise spinal cord vsls crvl","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2742.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65105","name":"Remove eye/attach implant","description":"Enucleation of eye; with implant, muscles attached to implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32551","name":"Insertion of chest tube","description":"Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78587","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22515","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3011.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69661","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96417","name":"Chemo iv infus each addl seq","description":"Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33813","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41017","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64790","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; major peripheral nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69711","name":"Remove/repair hearing aid","description":"Removal or repair of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96935","name":"Rcm img acquisj only ea addl","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8584.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63020","name":"Lamot dcmprn nrv rt 1 cerv","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19288","name":"Perq dev breast add mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9043","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"P9040","name":"Rbc leukoreduced irradiated","description":"Red blood cells, leukocytes reduced, irradiated, each unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62362","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97811","name":"Acup 1/> w/o estim ea add 15","description":"Acupuncture, 1 or more needles; without electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4210","name":"Orth dev repair/repl minor p","description":"Repair of orthotic device, repair or replace minor parts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"89140","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17350.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87340","name":"Hepatitis b surface ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21421","name":"Cltx palatal/max fx wire fix","description":"Closed treatment of palatal or maxillary fracture (lefort i type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77416","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86890","name":"Autologous blood process","description":"Autologous blood or component, collection processing and storage; predeposited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4183.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4541","name":"Large disposable underpad","description":"Incontinence product, disposable underpad, large, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26860","name":"Fusion of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66985","name":"Insert lens prosthesis","description":"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31651","name":"Bronchial valve addl insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (list separately in addition to code for primary procedure[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69717","name":"Rplcmt oi implt skl prq esp","description":"Replacement (including removal of existing device), osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86155","name":"Chemotaxis assay","description":"Chemotaxis assay, specify method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4554","name":"Disposable underpads","description":"Disposable underpads, all sizes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63290","name":"Bx/exc xdrl/idrl lsn any lvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4197","name":"Parenteral sol 74-100 gm pro","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements and vitamins, including preparation, any strength, 74 to 100 grams of protein - premix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88152","name":"Cytopath c/v auto redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"ATP03","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"17286","name":"Dstr mal ls f/e/e/n/l/m>4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33361","name":"Replace aortic valve perq","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; percutaneous femoral artery approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27598","name":"Amputate lower leg at knee","description":"Disarticulation at knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43107","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35474","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3966.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0247","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32608","name":"Thoracoscopy w/bx nodule","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3672","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41000","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43258","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0109","name":"Diab manage trn ind/group","description":"Diabetes outpatient self-management training services, group session (2 or more), per 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"Init pm e/m new pat 1-4 yrs","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35508","name":"Art byp grft carotid-vertbrl","description":"Bypass graft, with vein; carotid-vertebral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94350","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63278","name":"Bx/exc xdrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3290.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4306","name":"Drug delivery system <=50 ml","description":"Disposable drug delivery system, flow rate of less than 50 ml per hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"45339","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5376.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19367","name":"Brst rcnstj 1 pdcl tram flap","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17262","name":"Dstrj mal les t/a/l 1.1-2.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93356","name":"Myocrd strain img spckl trck","description":"Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (list separately in addition to codes for echocardiography imaging)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60220","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99425","name":"Prin care mgmt phys ea addl","description":"Principal care management services, for a single high-risk disease, with the following required elements: one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/decompensation, functional decline, or de","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80172","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67975","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83840","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0337","name":"Hospice evaluation preelecti","description":"Hospice evaluation and counseling services, pre-election","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32855","name":"Prepare donor lung single","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27328","name":"Exc thigh/knee tum deep <5cm","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93503","name":"Insert/place heart catheter","description":"Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98960","name":"Edu&trn pt self-mgmt nqhp 1","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46710","name":"Repr per/vag pouch sngl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38300","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28320","name":"Repair of foot bones","description":"Repair, nonunion or malunion; tarsal bones","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7900","name":"Male vacuum erection system","description":"Male vacuum erection system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4458","name":"Reusable enema bag","description":"Enema bag with tubing, reusable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51795","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26685","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61330","name":"Dcmprn orbit only transcrnl","description":"Decompression of orbit only, transcranial approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15276","name":"Skin sub graft f/n/hf/g addl","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6205","name":"Composite drsg > 48 sq in","description":"Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47001","name":"Ndl biopsy lvr tm oth maj px","description":"Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2456.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28825","name":"Partial amputation of toe","description":"Amputation, toe; interphalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92315","name":"C-lens fitg tech aphakia 1","description":"Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, 1 eye","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29895","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26020","name":"Drain hand tendon sheath","description":"Drainage of tendon sheath, digit and/or palm, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15420","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67805","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, different lids","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27193","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2114.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35304","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99172","name":"Ocular function screen","description":"Visual function screening, automated or semi-automated bilateral quantitative determination of visual acuity, ocular alignment, color vision by pseudoisochromatic plates, and field of vision (may include all or some screening of the determination[s] for contrast sensitivity, vision under glare)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33140","name":"Heart revascularize (tmr)","description":"Transmyocardial laser revascularization, by thoracotomy; (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22523","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64636","name":"Destroy l/s facet jnt addl","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); lumbar or sacral, each additional facet joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35633","name":"Bpg ilio-mesenteric","description":"Bypass graft, with other than vein; ilio-mesenteric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63030","name":"Lamot dcmprn nrv rt 1 lmbr","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96521","name":"Refill/maint portable pump","description":"Refilling and maintenance of portable pump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51565","name":"Revise bladder & ureter(s)","description":"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00882","name":"Anes maj lwr adb vsl ivc lig","description":"Anesthesia for procedures on major lower abdominal vessels; inferior vena cava ligation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31520","name":"Dx laryngoscopy newborn","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80416","name":"Renin stimulation panel","description":"Renal vein renin stimulation panel (eg, captopril) this panel must include the following: renin (84244 x 6)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"69646","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0464","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20696","name":"App mltpln uni xtrnl fix 1st","description":"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21610","name":"Costotransversectomy","description":"Costotransversectomy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6491.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87621","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82172","name":"Assay of apolipoprotein","description":"Apolipoprotein, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49618","name":"Rpr aa hrn rcr > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), recurrent, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63305","name":"Remove vert idrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2296.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C1879","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69644","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3371.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21421","name":"Cltx palatal/max fx wire fix","description":"Closed treatment of palatal or maxillary fracture (lefort i type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59870","name":"Evacuate mole of uterus","description":"Uterine evacuation and curettage for hydatidiform mole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64517","name":"N block inj hypogas plxs","description":"Injection, anesthetic agent; superior hypogastric plexus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35112","name":"Repair artery rupture spleen","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67312","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 horizontal muscles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33774","name":"Rpr tga atrial baffle px","description":"Repair of transposition of the great arteries, atrial baffle procedure (eg, mustard or senning type) with cardiopulmonary bypass;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38746","name":"Remove thoracic lymph nodes","description":"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20692","name":"Appl mltpln uni ext fixj sys","description":"Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, ilizarov, monticelli type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0323","name":"Care manage beh svs 20mins","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-u","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6784.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"U0003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1790.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40820","name":"Treatment of mouth lesion","description":"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80164","name":"Assay dipropylacetic acd tot","description":"Valproic acid (dipropylacetic acid); total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93528","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"49587","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28546","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87905","name":"Ia nzmtc actv oth/thn virus","description":"Infectious agent enzymatic activity other than virus (eg, sialidase activity in vaginal fluid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43757","name":"Dx duod intub w/asp specs","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17266","name":"Dstrj mal les t/a/l >4.0 cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82030","name":"Assay of adp & amp","description":"Adenosine, 5-monophosphate, cyclic (cyclic amp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46712","name":"Repr per/vag pouch dbl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74183","name":"Mri abd w/o cntr flwd cntr","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s), followed by with contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81276","name":"Kras gene addl variants","description":"Kras (kirsten rat sarcoma viral oncogene homolog) (eg, carcinoma) gene analysis; additional variant(s) (eg, codon 61, codon 146)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0121","name":"Colon ca scrn not hi rsk ind","description":"Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","53"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99422","name":"Ol dig e/m svc 11-20 min","description":"Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61107","name":"Tdh pnxr implt ventr cath","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77418","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43275","name":"Ercp remove forgn body duct","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5508","name":"Diabetic deluxe shoe","description":"For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61582","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33225","name":"L ventric pacing lead add-on","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4651","name":"Calibrated microcap tube","description":"Calibrated microcapillary tube, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21470","name":"Optx complicated mndblr fx","description":"Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86778","name":"Toxoplasma antibody igm","description":"Antibody; toxoplasma, igm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3526.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84119","name":"Test urine for porphyrins","description":"Porphyrins, urine; qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92325","name":"Modification of contact lens","description":"Modification of contact lens (separate procedure), with medical supervision of adaptation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63064","name":"Decompress spinal cord thrc","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2903.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93460","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84156","name":"Assay of protein urine","description":"Protein, total, except by refractometry; urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43045","name":"Esophagotomy thrc rmvl fb","description":"Esophagotomy, thoracic approach, with removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20670","name":"Removal implant superficial","description":"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67334","name":"Revise eye muscle w/suture","description":"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10970.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5999","name":"Lowr extremity prosthes nos","description":"Lower extremity prosthesis, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1441.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33243","name":"Remove eltrd/thoracotomy","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0024","name":"Pin srv add 30 min pr m","description":"Principal illness navigation services, additional 30 minutes per calendar month (list separately in addition to g0023)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7234.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32672","name":"Thoracoscopy for lvrs","description":"Thoracoscopy, surgical; with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction (lvrs), unilateral includes any pleural procedure, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57545","name":"Remove cervix/repair pelvis","description":"Excision of cervical stump, abdominal approach; with pelvic floor repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23331","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24940","name":"Revision of upper arm","description":"Cineplasty, upper extremity, complete procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96932","name":"Rcm img acquisj only 1st les","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, first lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44005","name":"Freeing of bowel adhesion","description":"Enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67550","name":"Insert eye socket implant","description":"Orbital implant (implant outside muscle cone); insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78594","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0309","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27216","name":"Treat pelvic ring fracture","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17106","name":"Dstr cut vsc prlf les<10sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99173","name":"Visual acuity screen","description":"Screening test of visual acuity, quantitative, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22853","name":"Insj biomechanical device","description":"Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (list separately in addition to code fo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27441","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6008","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82552","name":"Assay of cpk in blood","description":"Creatine kinase (ck), (cpk); isoenzymes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47555","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with dilation of biliary duct stricture(s) without stent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76497","name":"Unlisted ct procedure","description":"Unlisted computed tomography procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92582","name":"Conditioning play audiometry","description":"Conditioning play audiometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36468","name":"Njx sclrsnt spider veins","description":"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4098","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15600","name":"Delay flap trunk","description":"Delay of flap or sectioning of flap (division and inset); at trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66982","name":"Xcapsl ctrc rmvl cplx wo ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26860","name":"Fusion of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32994","name":"Ablate pulm tumor perq crybl","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; cryoablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37193","name":"Rem endovas vena cava filter","description":"Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","HA"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11047","name":"Dbrdmt bone each addl","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64455","name":"Njx aa&/strd pltr com dg nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, mortons neuroma)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51500","name":"Removal of bladder cyst","description":"Excision of urachal cyst or sinus, with or without umbilical hernia repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33933","name":"Prepare donor heart/lung","description":"Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and trachea for implantation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33224","name":"Insert pacing lead & connect","description":"Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of existing generator)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15271","name":"Skin sub graft trnk/arm/leg","description":"Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23184","name":"Prtl excision bone prox hum","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81320","name":"Plcg2 gene common variants","description":"Plcg2 (phospholipase c gamma 2) (eg, chronic lymphocytic leukemia) gene analysis, common variants (eg, r665w, s707f, l845f)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25695","name":"Optx lunate dislocation","description":"Open treatment of lunate dislocation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35141","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20220","name":"Bone biopsy trocar/ndl supfc","description":"Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84591","name":"Assay of nos vitamin","description":"Vitamin, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87336","name":"Entamoeb hist dispr ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica dispar group","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11626","name":"Exc s/n/h/f/g mal+mrg >4 cm","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95713","name":"Veeg 2-12 hr cont mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47533","name":"Plmt biliary drainage cath","description":"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3524.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31233","name":"Nsl/sins ndsc dx max sinusc","description":"Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47532","name":"Injection for cholangiogram","description":"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; new access (eg, percutaneous transhepatic cholangiogram)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25394","name":"Repair carpal bone shorten","description":"Osteoplasty, carpal bone, shortening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98968","name":"Ph1 assmt&mgmt nqhp 21-30","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11306","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28292","name":"Cor hlx vlgs rsc prx phlx bs","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8778.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50230","name":"Removal kidney open radical","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62370","name":"Anl sp inf pmp w/mdreprg&fil","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring skill of a physician or other qualified health care professional)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63660","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90833","name":"Psytx w pt w e/m 30 min","description":"Psychotherapy, 30 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0311","name":"Immunize counsel 16-30 mins","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service,  16-30 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61521","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2943.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61530","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43135","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19303","name":"Mast simple complete","description":"Mastectomy, simple, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443T","name":"R-t spctrl alys prst8 tiss","description":"Real-time spectral analysis of prostate tissue by fluorescence spectroscopy, including imaging guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86243","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65771","name":"Radial keratotomy","description":"Radial keratotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77435","name":"Sbrt management","description":"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58262","name":"Vag hyst including t/o","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94002","name":"Vent mgmt inpat init day","description":"Ventilation assist and management, initiation of pressure or volume preset ventilators for assisted or controlled breathing; hospital inpatient/observation, initial day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14300","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94774","name":"Ped home apnea mntr evnt rec","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; includes monitor attachment, download of data, review, interpretation, and preparation of a report by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86713","name":"Legionella antibody","description":"Antibody; legionella","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61512","name":"Crnec treph exc mngioma sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23044","name":"Arthrt ac sc jt exp/rmvl fb","description":"Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87328","name":"Cryptosporidium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cryptosporidium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21199","name":"Reconstr lwr jaw w/advance","description":"Osteotomy, mandible, segmental; with genioglossus advancement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25101","name":"Explore/treat wrist joint","description":"Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21497","name":"Interdental wirg oth/thn fx","description":"Interdental wiring, for condition other than fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87652","name":"Strep a dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84449","name":"Assay of transcortin","description":"Transcortin (cortisol binding globulin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0884","name":"Pwc gp4 std mult pow opt s/b","description":"Power wheelchair, group 4 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40652","name":"Rpr lip fth<half ver height","description":"Repair lip, full thickness; up to half vertical height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24079","name":"Rad rescj tum tiss a/e 5 cm+","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49596","name":"Rpr aa hrn 1st > 10 ncr/strn","description":"Repair of anterior abdominal hernia(s) (ie, epigastric, incisional, ventral, umbilical, spigelian), any approach (ie, open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed, total length of defect(s); greater than 10 cm, incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88148","name":"Cytopath c/v auto rescreen","description":"Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49020","name":"Drainage abdom abscess open","description":"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99143","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68360","name":"Revise eyelid lining","description":"Conjunctival flap; bridge or partial (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27071","name":"Part removal hip bone deep","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); deep (subfascial or intramuscular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27822","name":"Treatment of ankle fracture","description":"Open treatment of trimalleolar ankle fracture, includes internal fixation, when performed, medial and/or lateral malleolus; without fixation of posterior lip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87426","name":"Sarscov coronavirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3677","name":"So hard plas stabili pre cst","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50436","name":"Dilat xst trc ndurlgc px","description":"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43881","name":"Impl/rplcmt gstr nstim eltrd","description":"Implantation or replacement of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63077","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2812.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54416","name":"Remv/repl penis contain pros","description":"Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15301","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67875","name":"Closure of eyelid by suture","description":"Temporary closure of eyelids by suture (eg, frost suture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82777","name":"Galectin-3","description":"Galectin-3","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15300","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47537","name":"Removal biliary drg cath","description":"Removal of biliary drainage catheter, percutaneous, requiring fluoroscopic guidance (eg, with concurrent indwelling biliary stents), including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31239","name":"Nsl/sinus endoscopy surg dcr","description":"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57720","name":"Revision of cervix","description":"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77338","name":"Design mlc device for imrt","description":"Multi-leaf collimator (mlc) device(s) for intensity modulated radiation therapy (imrt), design and construction per imrt plan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50432","name":"Plmt nephrostomy catheter","description":"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61886","name":"Implant neurostim arrays","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1831.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78496","name":"Heart first pass add-on","description":"Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right ventricular ejection fraction by first pass technique (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1501.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1816","name":"Sps/pass ankle device","description":"Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84560","name":"Assay of urine/uric acid","description":"Uric acid; other source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29826","name":"Sho arthrs srg decompression","description":"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4231","name":"Infusion insulin pump needle","description":"Infusion set for external insulin pump, needle type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0562T","name":"Antmc guide 3d print ea addl","description":"Anatomic guide 3d-printed and designed from image data set(s); each additional anatomic guide (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43045","name":"Esophagotomy thrc rmvl fb","description":"Esophagotomy, thoracic approach, with removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31390","name":"Removal of larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; without reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86668","name":"Francisella tularensis","description":"Antibody; francisella tularensis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90811","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36148","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43865","name":"Revj gstr/jj anast w/vgtmy","description":"Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without partial gastrectomy or intestine resection; with vagotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11624","name":"Exc s/n/h/f/g mal+mrg 3.1-4","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54160","name":"Circumcision neonate","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53260","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral polyp(s), distal urethra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49553","name":"Rpr fem hernia init blocked","description":"Repair initial femoral hernia, any age; incarcerated or strangulated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47536","name":"Exchange biliary drg cath","description":"Exchange of biliary drainage catheter (eg, external, internal-external, or conversion of internal-external to external only), percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21194","name":"Reconst lwr jaw w/graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; with bone graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61460","name":"Crnec sopl sctj 1+crnl nrv","description":"Craniectomy, suboccipital; for section of 1 or more cranial nerves","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65290","name":"Repair of eye socket wound","description":"Repair of wound, extraocular muscle, tendon and/or tenons capsule","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64713","name":"Revision of arm nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80048","name":"Basic metabolic pnl total ca","description":"Basic metabolic panel (calcium, total) this panel must include the following: calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64568","name":"Opn impltj crnl nrv nea&pg","description":"Open implantation of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68130","name":"Exc les conjunctiva adj scl","description":"Excision of lesion, conjunctiva; with adjacent sclera","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50815","name":"Urine shunt to intestine","description":"Ureterocolon conduit, including intestine anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10010","name":"Fna bx w/ct gdn ea addl","description":"Fine needle aspiration biopsy, including ct guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35207","name":"Rpr bld vsl dir hand finger","description":"Repair blood vessel, direct; hand, finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64417","name":"Njx aa&/strd ax nerve img","description":"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63005","name":"Remove spine lamina 1/2 lmbr","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; lumbar, except for spondylolisthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87335","name":"E coli 0157 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; escherichia coli 0157","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67042","name":"Vit for macular hole","description":"Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84035","name":"Assay of phenylketones","description":"Phenylketones, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"53440","name":"Male sling procedure","description":"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4178","name":"Parenteral sol amino acid >","description":"Parenteral nutrition solution: amino acid, greater than 8.5% (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54522","name":"Orchiectomy partial","description":"Orchiectomy, partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3619.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33258","name":"Ablate atria x10sv add-on","description":"Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5020.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4680.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43275","name":"Ercp remove forgn body duct","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59614","name":"Vbac care after delivery","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27496","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47701","name":"Bile duct revision","description":"Portoenterostomy (eg, kasai procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69530","name":"Extensive mastoid surgery","description":"Petrous apicectomy including radical mastoidectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4102","name":"Ef adult fluids and electro","description":"Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0564T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50360","name":"Rnl altrnsplj w/o rcp nfrct","description":"Renal allotransplantation, implantation of graft; without recipient nephrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28540","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99473","name":"Self-meas bp pt educaj/train","description":"Self-measured blood pressure using a device validated for clinical accuracy; patient education/training and device calibration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15847","name":"Exc skin abd add-on","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23076","name":"Exc shoulder tum deep < 5 cm","description":"Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29015","name":"Appl rissr jacket bdy w/head","description":"Application of risser jacket, localizer, body; including head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46258","name":"Remove in/ex hem grp w/fistu","description":"Hemorrhoidectomy, internal and external, single column/group; with fistulectomy, including fissurectomy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61686","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33369","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0451","name":"Devlopment test interpt&rep","description":"Development testing, with interpretation and report, per standardized instrument form","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4158.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31531","name":"Laryngoscopy w/fb & op scope","description":"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33779","name":"Rpr tga rcnstj rmvl plm bnd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with removal of pulmonary band","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20690","name":"Appl unipln uni ext fixj sys","description":"Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27610","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22512","name":"Vertebroplasty addl inject","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60512","name":"Autotransplant parathyroid","description":"Parathyroid autotransplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67900","name":"Repair brow defect","description":"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25671","name":"Perq skel fix rad/uln dislc","description":"Percutaneous skeletal fixation of distal radioulnar dislocation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27781","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0297T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64447","name":"Njx aa&/strd femoral nrv img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12047","name":"Intmd rpr n-hf/genit >30.0cm","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99221","name":"1st hosp ip/obs sf/low 40","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level medical decision making. when using total time on the date of the encounter for code selection, ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0456","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2322.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99224","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3464.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12055","name":"Intmd rpr face/mm 12.6-20 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64484","name":"Njx aa&/strd tfrm epi l/s ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), lumbar or sacral, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75954","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61520","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3410.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99359","name":"Prolong serv w/o contact add","description":"Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (list separately in addition to code for prolonged service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28011","name":"Incision of toe tendons","description":"Tenotomy, percutaneous, toe; multiple tendons","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92342","name":"Fit spectacles multifocal","description":"Fitting of spectacles, except for aphakia; multifocal, other than bifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96160","name":"Pt-focused hlth risk assmt","description":"Administration of patient-focused health risk assessment instrument (eg, health hazard appraisal) with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38792","name":"Ra tracer id of sentinl node","description":"Injection procedure; radioactive tracer for identification of sentinel node","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63172","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44620","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15734","name":"Muscle-skin graft trunk","description":"Muscle, myocutaneous, or fasciocutaneous flap; trunk","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98970","name":"Nqhp ol dig assmt&mgmt 5-10","description":"Nonphysician qualified health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11406","name":"Exc tr-ext b9+marg >4.0 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25115","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); flexors","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2634.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49405","name":"Image cath fluid colxn visc","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, lung/mediastinum), percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86644","name":"Cmv antibody","description":"Antibody; cytomegalovirus (cmv)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4193","name":"Parenteral sol 52-73 gm prot","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27592","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; open, circular (guillotine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55842","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81185","name":"Cacna1a gene full gene seq","description":"Cacna1a (calcium voltage-gated channel subunit alpha1 a) (eg, spinocerebellar ataxia) gene analysis; full gene sequence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2073.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25825","name":"Arthrd wrist with autograft","description":"Arthrodesis, wrist; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33606","name":"Anastomosis/artery-aorta","description":"Anastomosis of pulmonary artery to aorta (damus-kaye-stansel procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55821","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36483","name":"Endoven ther chem adhes sbsq","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; subsequent vein(s) treated in a single extremity, each through separate access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27442","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61799","name":"Srs cran les complex addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"81274","name":"Htt gene charac alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34804","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51800","name":"Revision of bladder/urethra","description":"Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96440","name":"Chmotx admn plrl cav thrcnts","description":"Chemotherapy administration into pleural cavity, requiring and including thoracentesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93652","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33415","name":"Revision subvalvular tissue","description":"Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92950","name":"Heart/lung resuscitation cpr","description":"Cardiopulmonary resuscitation (eg, in cardiac arrest)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68816","name":"Probe nl duct w/balloon","description":"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39501","name":"Repair diaphragm laceration","description":"Repair, laceration of diaphragm, any approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71060","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37243","name":"Vasc embolize/occlude organ","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35102","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving iliac vessels (common, hypogastric, external)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35188","name":"Rpr acq av fistula head&neck","description":"Repair, acquired or traumatic arteriovenous fistula; head and neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31370","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); horizontal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68750","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30560","name":"Lysis intranasal synechia","description":"Lysis intranasal synechia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46608","name":"Anoscopy remove for body","description":"Anoscopy; with removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64727","name":"Internal neurolysis","description":"Internal neurolysis, requiring use of operating microscope (list separately in addition to code for neuroplasty) (neuroplasty includes external neurolysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20931","name":"Sp bone algrft struct add-on","description":"Allograft, structural, for spine surgery only (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93457","name":"R hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27767","name":"Cltx post ankle fx","description":"Closed treatment of posterior malleolus fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82728","name":"Assay of ferritin","description":"Ferritin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96376","name":"Tx/pro/dx inj same drug adon","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99476","name":"Ped crit care age 2-5 subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0321","name":"Audio-only hhs","description":"Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31297","name":"Nsl/sins ndsc surg sphn sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27519","name":"Treat thigh fx growth plate","description":"Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95149","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 5 single stinging insect venoms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"C1879","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"H0001","name":"Alcohol and/or drug assess","description":"Alcohol and/or drug assessment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27386","name":"Repair/graft of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35304","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42104","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; without closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41112","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; anterior two-thirds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41008","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0240","name":"Bath/shower chair","description":"Bath/shower chair, with or without wheels, any size","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27607","name":"Treat lower leg bone lesion","description":"Incision (eg, osteomyelitis or bone abscess), leg or ankle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51795","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47136","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94070","name":"Evaluation of wheezing","description":"Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9955","name":"Inj perflexane lip micros,ml","description":"Injection, perflexane lipid microspheres, per ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52315","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93012","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58575","name":"Laps tot hyst resj mal","description":"Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61600","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92018","name":"Compl oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31786","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35612","name":"Bpg subclavian-subclavian","description":"Bypass graft, with other than vein; subclavian-subclavian","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81271","name":"Htt gene detc abnor alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15760","name":"Composite skin graft","description":"Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86747","name":"Parvovirus antibody","description":"Antibody; parvovirus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49520","name":"Rerepair ing hernia reduce","description":"Repair recurrent inguinal hernia, any age; reducible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63295","name":"Repair laminectomy defect","description":"Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3389.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36620","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58263","name":"Vag hyst w/t/o & vag repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50384","name":"Remove ureter stent percut","description":"Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75993","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44382","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63301","name":"Remove vert xdrl body thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21436","name":"Optx crnfcl sep comp mlt int","description":"Open treatment of craniofacial separation (lefort iii type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21142","name":"Rcnstj midface lefort i 2pcs","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, without bone graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49324","name":"Lap insert tunnel ip cath","description":"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33997","name":"Rmvl perq right heart vad","description":"Removal of percutaneous right heart ventricular assist device, venous cannula, at separate and distinct session from insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84146","name":"Assay of prolactin","description":"Prolactin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12046","name":"Intmd rpr n-hf/genit20.1-30","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4104","name":"Additive for enteral formula","description":"Additive for enteral formula (e.g., fiber)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32655","name":"Thoracoscopy resect bullae","description":"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43107","name":"Removal of esophagus","description":"Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (transhiatal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2482.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92201","name":"Opscpy extnd rta draw uni/bi","description":"Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (eg, for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90964","name":"Esrd home pt serv p mo 2-11","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87903","name":"Phenotype dna hiv w/culture","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; first through 10 drugs tested","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31580","name":"Laryngoplasty laryngeal web","description":"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42106","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with simple primary closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2324.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97130","name":"Ther ivntj ea addl 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0237T","name":"Trluml perip athrc brchiocph","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G2083","name":"Visit esketamine, > 56m","description":"Office or other outpatient visit for the evaluation and management of an established patient that requires the supervision of a physician or other qualified health care professional and provision of  greater than 56 mg esketamine nasal self-administration, includes 2 hours post-administration observ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5441.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58800","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22206","name":"Incis spine 3 column thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0441","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90870","name":"Electroconvulsive therapy","description":"Electroconvulsive therapy (includes necessary monitoring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28420","name":"Optx calcaneal fx w/bone grf","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6022","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20816","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4532","name":"Ped size pull-on lg","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26485","name":"Transplant palm tendon","description":"Transfer or transplant of tendon, palmar; without free tendon graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63303","name":"Remov vert xdrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25112","name":"Reremove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); recurrent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90962","name":"Esrd serv 1 visit p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 1 face-to-face visit by a physician or other qualified health care professional per month","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50553","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90953","name":"Esrd serv 1 visit p mo <2yrs","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97803","name":"Med nutrition indiv subseq","description":"Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28088","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; extensor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34826","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58267","name":"Vag hyst w/urinary repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (marshall-marchetti-krantz type, pereyra type) with or without endoscopic control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53446","name":"Remove uro sphincter","description":"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25240","name":"Partial removal of ulna","description":"Excision distal ulna partial or complete (eg, darrach type or matched resection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82544","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28615","name":"Repair foot dislocation","description":"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27752","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33273","name":"Repos prev impltbl subq dfb","description":"Repositioning of previously implanted subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95992","name":"Canalith repositioning proc","description":"Canalith repositioning procedure(s) (eg, epley maneuver, semont maneuver), per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"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":"2026-06-06","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":["CSTM-00"],"billing_code_modifier":["SL","HA"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36570","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63042","name":"Laminotomy single lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42808","name":"Excise pharynx lesion","description":"Excision or destruction of lesion of pharynx, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95712","name":"Veeg 2-12 hr intmt mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; with intermittent monitoring and maintenance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23655","name":"Cltx sho dslc w/mnpj w/anes","description":"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82610","name":"Cystatin c","description":"Cystatin c","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21123","name":"Geniop sldg augmentation","description":"Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38207","name":"Cryopreserve stem cells","description":"Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11313","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"M0245","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87140","name":"Culture type immunofluoresc","description":"Culture, typing; immunofluorescent method, each antiserum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31643","name":"Diag bronchoscope/catheter","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of catheter(s) for intracavitary radioelement application","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21050","name":"Removal of jaw joint","description":"Condylectomy, temporomandibular joint (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38555","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21345","name":"Closed tx nose/jaw fx","description":"Closed treatment of nasomaxillary complex fracture (lefort ii type), with interdental wire fixation or fixation of denture or splint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"55400","name":"Repair of sperm duct","description":"Vasovasostomy, vasovasorrhaphy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64886","name":"Nerve graft head/neck >4 cm","description":"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6004","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80415","name":"Tot estradiol response panel","description":"Chorionic gonadotropin stimulation panel; estradiol response this panel must include the following: estradiol, total (82670 x 2 on 3 pooled blood samples)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0240","name":"Bath/shower chair","description":"Bath/shower chair, with or without wheels, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69643","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33363","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open axillary artery approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57260","name":"Cmbn ant pst colprhy","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86906","name":"Bld typing serologic rh phnt","description":"Blood typing, serologic; rh phenotyping, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88313","name":"Special stains group 2","description":"Special stain including interpretation and report; group ii, all other (eg, iron, trichrome), except stain for microorganisms, stains for enzyme constituents, or immunocytochemistry and immunohistochemistry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20240","name":"Bone biopsy open superficial","description":"Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36145","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28011","name":"Incision of toe tendons","description":"Tenotomy, percutaneous, toe; multiple tendons","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87901","name":"Nfct agt gntyp alys hiv1 rev","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, reverse transcriptase and protease regions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87267","name":"Enterovirus antibody dfa","description":"Infectious agent antigen detection by immunofluorescent technique; enterovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29870","name":"Arthrs knee dx w/wo syn bx","description":"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42215","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; major revision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46938","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77407","name":"Radiation tx delivery lvl 2","description":"Radiation treatment delivery; level 2, single-isocenter (eg, 3d or imrt), photons, including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28436","name":"Prq skel fix talus fx w/mnpj","description":"Percutaneous skeletal fixation of talus fracture, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19120","name":"Removal of breast lesion","description":"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26205","name":"Remove/graft bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0289","name":"Arthro, loose body + chondro","description":"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21558","name":"Resect neck tumor 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82143","name":"Amniotic fluid scan","description":"Amniotic fluid scan (spectrophotometric)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81337","name":"Smn1 gen nown famil seq vrnt","description":"Smn1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; known familial sequence variant(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41015","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92506","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6026.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97035","name":"App mdlty 1+ultrasound ea 15","description":"Application of a modality to 1 or more areas; ultrasound, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90815","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28465","name":"Optx tarsal bone fx each","description":"Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82379","name":"Assay of carnitine","description":"Carnitine (total and free), quantitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33694","name":"Cmp rpr tof wo plm atrs ptch","description":"Complete repair tetralogy of fallot without pulmonary atresia; with transannular patch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64792","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; extensive (including malignant type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66175","name":"Trluml dil aq o/f can w/st","description":"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22903","name":"Exc abd les sc 3 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93325","name":"Doppler echo color flow mapg","description":"Doppler echocardiography color flow velocity mapping (list separately in addition to codes for echocardiography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0353T","name":"Intraop oct breast cavity","description":"Optical coherence tomography of breast, surgical cavity; real-time intraoperative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53415","name":"Reconstruction of urethra","description":"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82139","name":"Amino acids quan 6 or more","description":"Amino acids, 6 or more amino acids, quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82136","name":"Amino acids quant 2-5","description":"Amino acids, 2 to 5 amino acids, quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58410","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; with presacral sympathectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69660","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8584.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31574","name":"Largsc w/njx augmentation","description":"Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8244.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99349","name":"Home/res vst est mod mdm 40","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or excee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21014","name":"Exc face tum deep 2 cm/>","description":"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68530","name":"Clearance of tear duct","description":"Removal of foreign body or dacryolith, lacrimal passages","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33502","name":"Coronary artery correction","description":"Repair of anomalous coronary artery from pulmonary artery origin; by ligation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87486","name":"Chlmyd pneum dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96935","name":"Rcm img acquisj only ea addl","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition only, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63266","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0217T","name":"Njx paravert w/us lumb/sac","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, lumbar or sacral; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6306.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46200","name":"Removal of anal fissure","description":"Fissurectomy, including sphincterotomy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84220","name":"Assay of pyruvate kinase","description":"Pyruvate kinase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"98967","name":"Ph1 assmt&mgmt nqhp 11-20","description":"Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management se","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27618","name":"Exc leg/ankle tum < 3 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22207","name":"Incis spine 3 column lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42802","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67105","name":"Repair detached retina pc","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80047","name":"Basic metablc pnl ionized ca","description":"Basic metabolic panel (calcium, ionized) this panel must include the following: calcium, ionized (82330) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5783.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26850","name":"Fusion of knuckle","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33610","name":"Repair by enlargement","description":"Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96440","name":"Chmotx admn plrl cav thrcnts","description":"Chemotherapy administration into pleural cavity, requiring and including thoracentesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95830","name":"Insert electrodes for eeg","description":"Insertion by physician or other qualified health care professional of sphenoidal electrodes for electroencephalographic (eeg) recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57311","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula; with bulbocavernosus transplant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83505","name":"Assay total hydroxyproline","description":"Hydroxyproline; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50715","name":"Release of ureter","description":"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1893","name":"Intro/sheath, fixed,non-peel","description":"Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95936","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36596","name":"Mech remov tunneled cv cath","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84120","name":"Assay of urine porphyrins","description":"Porphyrins, urine; quantitation and fractionation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43314","name":"Tracheo-esophagoplasty cong","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with repair of congenital tracheoesophageal fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"Office o/p new hi 60 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17312","name":"Mohs addl stage","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), h","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25300","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; flexors of fingers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33889","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40818","name":"Excise oral mucosa for graft","description":"Excision of mucosa of vestibule of mouth as donor graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86707","name":"Hepatitis be antibody","description":"Hepatitis be antibody (hbeab)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7679.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3249.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50557","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69745","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78431","name":"Myocrd img pet rst&strs ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1416.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93788","name":"Ambl bp mntr w/sw a/r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; scanning analysis with report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22857","name":"Tot disc arthrp 1ntrspc lmbr","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69401","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["KM","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15340","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90802","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35881","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81171","name":"Aff2 gen aly detc abnl allel","description":"Aff2 (alf transcription elongation factor 2 [fmr2]) (eg, fragile x intellectual disability 2 [fraxe]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29873","name":"Arthrs knee surg w/lat rls","description":"Arthroscopy, knee, surgical; with lateral release","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15941","name":"Exc isch pr ulc prm sut ostc","description":"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29879","name":"Arthrs kne srg abrasj arthrp","description":"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45120","name":"Removal of rectum","description":"Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull-through procedure and anastomosis (eg, swenson, duhamel, or soave type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2008","name":"Post-d/c h vst ext pt 45 m","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient fac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32201","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0439T","name":"Myocrd contrast prfuj echo","description":"Myocardial contrast perfusion echocardiography, at rest or with stress, for assessment of myocardial ischemia or viability (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15050","name":"Pinch graft up to 2 cm diam","description":"Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2396.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47371","name":"Laparo ablate liver cryosurg","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64832","name":"Repair nerve add-on","description":"Suture of digital nerve, hand or foot; each additional digital nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17313","name":"Mohs 1 stage t/a/l","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), o","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6017","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27396","name":"Transplant of thigh tendon","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); single tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3735.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88177","name":"Cytp fna eval ea addl","description":"Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis, each separate additional evaluation episode, same site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"Home/res vst new mod mdm 60","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9273","name":"Hot/cold botle/cap/col/wrap","description":"Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96912","name":"Photochemotherapy puva","description":"Photochemotherapy; psoralens and ultraviolet a (puva)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46261","name":"Remove in/ex hem grps & fiss","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0201T","name":"Perq sacral augmt bilat inj","description":"Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15750","name":"Neurovascular pedicle flap","description":"Flap; neurovascular pedicle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61151","name":"Burr hole/treph sbsq tapping","description":"Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial abscess or cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87536","name":"Hiv-1 quant&revrse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, quantification, includes reverse transcription when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11982","name":"Remove drug implant device","description":"Removal, non-biodegradable drug delivery implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"10160","name":"Pnxr aspir absc hmtma bulla","description":"Puncture aspiration of abscess, hematoma, bulla, or cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4046.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23020","name":"Capsular contracture release","description":"Capsular contracture release (eg, sever type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97166","name":"Ot eval mod complex 45 min","description":"Occupational therapy evaluation, moderate complexity, requiring these components: an occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current func","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31656","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33993","name":"Reposg perq r/l hrt vad","description":"Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43252","name":"Egd optical endomicroscopy","description":"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41115","name":"Excision of tongue fold","description":"Excision of lingual frenum (frenectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26215","name":"Remove/graft finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36560","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44388","name":"Colonoscopy thru stoma spx","description":"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43621","name":"Removal of stomach","description":"Gastrectomy, total; with roux-en-y reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31646","name":"Brnchsc w/ther aspir sbsq","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, subsequent, same hospital stay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64722","name":"Decompression unspec nerve","description":"Decompression; unspecified nerve(s) (specify)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14696.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31582","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11740","name":"Evacuation subungual hmtma","description":"Evacuation of subungual hematoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33736","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; open heart with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32506","name":"Wedge resect of lung add-on","description":"Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92352","name":"Fit aphakia spectcl monofocl","description":"Fitting of spectacle prosthesis for aphakia; monofocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21295","name":"Revision of jaw muscle/bone","description":"Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63015","name":"Remove spine lamina >2 crvcl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20972","name":"Bone/skin graft metatarsal","description":"Free osteocutaneous flap with microvascular anastomosis; metatarsal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2421.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95981","name":"Io anal gast n-stim subsq","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0503T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35697","name":"Reimplant artery each","description":"Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64642","name":"Chemodenerv 1 extremity 1-4","description":"Chemodenervation of one extremity; 1-4 muscle(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87380","name":"Hepatitis delta agent ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis, delta agent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29105","name":"Application long arm splint","description":"Application of long arm splint (shoulder to hand)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62005","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; compound or comminuted, extradural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87520","name":"Hepatitis c rna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53080","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; uncomplicated (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91038","name":"Esoph imped funct test > 1hr","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation; prolonged (greater than 1 hour, up to 24 hours)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87492","name":"Chlmyd trach dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95981","name":"Io anal gast n-stim subsq","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51020","name":"Cystotomy/cystostomy w/fulg","description":"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87040","name":"Blood culture for bacteria","description":"Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23700","name":"Mnpj anes sho jt fixj aprats","description":"Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43610","name":"Excision of stomach lesion","description":"Excision, local; ulcer or benign tumor of stomach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87493","name":"C diff amplified probe","description":"Infectious agent detection by nucleic acid (dna or rna); clostridium difficile, toxin gene(s), amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"23106","name":"Arthrotomy strnclav joint","description":"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53505","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; penile","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35650","name":"Bpg axillary-axillary","description":"Bypass graft, with other than vein; axillary-axillary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17271","name":"Dstr mal les s/n/h/f/g 0.6-1","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11720","name":"Debride nail 1-5","description":"Debridement of nail(s) by any method(s); 1 to 5","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33944","name":"Prepare donor heart","description":"Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left atrium for implantation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35686","name":"Bypass graft/av fist patency","description":"Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-hemodialysis) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36592","name":"Collect blood from picc","description":"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22861","name":"Rev rplcm arthrp 1ntrspc crv","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58760","name":"Fimbrioplasty","description":"Fimbrioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36905","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83893","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94774","name":"Ped home apnea mntr evnt rec","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; includes monitor attachment, download of data, review, interpretation, and preparation of a report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01933","name":"Anes ther ivntl rad px icr","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9282","name":"Wig any type","description":"Wig, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90819","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35521","name":"Art byp grft axill-femoral","description":"Bypass graft, with vein; axillary-femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34717","name":"Evasc rpr a-iliac ndgft","description":"Endovascular repair of iliac artery at the time of aorto-iliac artery endograft placement by deployment of an iliac branched endograft including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radiological supervision and interpret","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43337","name":"Thorabd diaphr hern repair","description":"Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59130","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; abdominal pregnancy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36000","name":"Place needle in vein","description":"Introduction of needle or intracatheter, vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"20970","name":"Bone/skin graft iliac crest","description":"Free osteocutaneous flap with microvascular anastomosis; iliac crest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2428.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95972","name":"Alys cplx sp/pn npgt w/prgrm","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11401","name":"Exc tr-ext b9+marg 0.6-1 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47300","name":"Surgery for liver lesion","description":"Marsupialization of cyst or abscess of liver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69705","name":"Nps surg dilat eust tube uni","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6254.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96131","name":"Psycl tst eval phys/qhp ea","description":"Psychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9516","name":"Iodine i-123 sod iodide mic","description":"Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4236.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2814.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84030","name":"Assay of blood pku","description":"Phenylalanine (pku), blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55700","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20606","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84061","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35491","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33410","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61703","name":"Clamp neck artery","description":"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (selverstone-crutchfield type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5764.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3306.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4527","name":"Adult size pull-on lg","description":"Adult sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92618","name":"Ex for nonspeech dev rx add","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0270","name":"Mnt subs tx for change dx","description":"Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15275","name":"Skin sub graft face/nk/hf/g","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4722","name":"Dialys sol fld vol > 1999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99364","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8053.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28104","name":"Removal of foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31730","name":"Intro windpipe wire/tube","description":"Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57307","name":"Fistula repair & colostomy","description":"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49568","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64480","name":"Njx aa&/strd tfrm epi c/t ea","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39560","name":"Resect diaphragm simple","description":"Resection, diaphragm; with simple repair (eg, primary suture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61790","name":"Treat trigeminal nerve","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82575","name":"Creatinine clearance test","description":"Creatinine; clearance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28515","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57308","name":"Fistula repair transperine","description":"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1755.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36566","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3774.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1985.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1486.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11750","name":"Excision nail&nail matrix","description":"Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38760","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, including cloquets node (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26497","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; ring and small finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37252","name":"Intrvasc us noncoronary 1st","description":"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; initial noncoronary vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32656","name":"Thoracoscopy w/pleurectomy","description":"Thoracoscopy, surgical; with parietal pleurectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29823","name":"Sho arthrs srg xtnsv dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the ro","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27200","name":"Treat tail bone fracture","description":"Closed treatment of coccygeal fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95131","name":"Immntx 2 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 2 stinging insect venoms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67031","name":"Laser surgery eye strands","description":"Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (1 or more stages)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57155","name":"Insert uteri tandem/ovoids","description":"Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35671","name":"Bpg pop-tibl/-prnl artery","description":"Bypass graft, with other than vein; popliteal-tibial or -peroneal artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28003","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2058","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58943","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515T","name":"Insj wcs lv compl sys","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; complete system (includes electrode and generator [transmitter and battery])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31257","name":"Nsl/sins ndsc tot w/sphendt","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95018","name":"All tstg perq&iq drugs/biol","description":"Allergy testing, any combination of percutaneous (scratch, puncture, prick) and intracutaneous (intradermal), sequential and incremental, with drugs or biologicals, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"Limited visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, autoplot, arc perimeter, or single stimulus level automated test, such as octopus 3 or 7 equivalent)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01938","name":"Anes drg/aspir lmbr/sac","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99283","name":"Emergency dept visit low mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28054","name":"Biopsy of toe joint lining","description":"Arthrotomy with biopsy; interphalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0421T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56637","name":"Vlvctmy rad comp bi lymphad","description":"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52356","name":"Cysto/uretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15935","name":"Exc sac pr ulc skn flp ostc","description":"Excision, sacral pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0332","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0005U","name":"Onco prst8 3 gene ur alg","description":"Oncology (prostate) gene expression profile by real-time rt-pcr of 3 genes (erg, pca3, and spdef), urine, algorithm reported as risk score","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62367","name":"Analyze spine infus pump","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); without reprogramming or refill","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53440","name":"Male sling procedure","description":"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62294","name":"Injection into spinal artery","description":"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23520","name":"Cltx strnclav dislc w/o mnpj","description":"Closed treatment of sternoclavicular dislocation; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27870","name":"Fusion of ankle joint open","description":"Arthrodesis, ankle, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40525","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with local flap (eg, estlander or fan)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49580","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86318","name":"Ia infectious agent antibody","description":"Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34826","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59871","name":"Remove cerclage suture","description":"Removal of cerclage suture under anesthesia (other than local)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83550","name":"Iron binding test","description":"Iron binding capacity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47141","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments ii, iii and iv)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57270","name":"Repair of bowel pouch","description":"Repair of enterocele, abdominal approach (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0084","name":"Care man h v ext pt 60 m","description":"Comprehensive (60 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93565","name":"Njx car cth slctv lv/la ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective left ventricular or left atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43262","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32656","name":"Thoracoscopy w/pleurectomy","description":"Thoracoscopy, surgical; with parietal pleurectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64804","name":"Sympathectomy cervicothorac","description":"Sympathectomy, cervicothoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88167","name":"Cytopath tbs c/v select","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); with manual screening and computer-assisted rescreening using cell selection and review under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7682.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33284","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58545","name":"Laparoscopic myomectomy","description":"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86077","name":"Phys blood bank serv xmatch","description":"Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and written report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30150","name":"Rhinectomy partial","description":"Rhinectomy; partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17270","name":"Dstr mal les s/n/h/f/g .5 /<","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0136","name":"Adm of pa/n assess 5-15 m","description":"Administration of a standardized, evidence-based assessment of physical activity and nutrition, 5-15 minutes, not more often than every 6 months","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87661","name":"Trichomonas vaginalis amplif","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87324","name":"Clostridium ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; clostridium difficile toxin(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51030","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63052","name":"Lam facetc/frmt arthrd lum 1","description":"Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11982.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85300","name":"Antithrombin iii activity","description":"Clotting inhibitors or anticoagulants; antithrombin iii, activity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32607","name":"Thoracoscopy w/bx infiltrate","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32856","name":"Prepare donor lung double","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3684.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87336","name":"Entamoeb hist dispr ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; entamoeba histolytica dispar group","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64822","name":"Sympathectomy ulnar artery","description":"Sympathectomy; ulnar artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2086","name":"Off base opioid tx 70min","description":"Office-based treatment for opioid use disorder, including development of the treatment plan, care coordination, individual therapy and group therapy and counseling; at least 70 minutes in the first calendar month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22103","name":"Remove extra spine segment","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96137","name":"Psycl/nrpsyc tst phy/qhp ea","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; each additional 30 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27227","name":"Treat hip fracture(s)","description":"Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1403.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24006","name":"Arthrt elbw capsl exc rls","description":"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2621.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27600","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82489","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67335","name":"Eye suture during surgery","description":"Placement of adjustable suture(s) during strabismus surgery, including postoperative adjustment(s) of suture(s) (list separately in addition to code for specific strabismus surgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65782","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87285","name":"Treponema pallidum ag if","description":"Infectious agent antigen detection by immunofluorescent technique; treponema pallidum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49491","name":"Rpr hern preemie reduc","description":"Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92311","name":"Contact lens fitg aphakia 1","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, 1 eye","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62010","name":"Treatment of head injury","description":"Elevation of depressed skull fracture; with repair of dura and/or debridement of brain","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11977","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67334","name":"Revise eye muscle w/suture","description":"Strabismus surgery by posterior fixation suture technique, with or without muscle recession (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93226","name":"Xtrnl ecg rec<48 hr scan a/r","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29065","name":"Appl cst sho to hand lng arm","description":"Application, cast; shoulder to hand (long arm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92015","name":"Determine refractive state","description":"Determination of refractive state","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15261","name":"Fth/gft fr n/e/e/l each addl","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0214T","name":"Njx paravert w/us cer/thor","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2063","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["KM","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63085","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47525","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2062.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42820","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; younger than age 12","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28092","name":"Removal of toe lesions","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); toe(s), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74178","name":"Ct abd&plv wo cntr flwd cntr","description":"Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7608.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64653","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73702","name":"Ct lwr extremity w/o&w/dye","description":"Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97124","name":"Massage therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52270","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; female","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77371","name":"Srs multisource","description":"Radiation treatment delivery, stereotactic radiosurgery (srs), complete course of treatment of cranial lesion(s) consisting of 1 session; multi-source cobalt 60 based","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64895","name":"Nrv grf mltst hnd/foot <4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up to 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8999","name":"Resuscitation bag","description":"Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86023","name":"Immunoglobulin assay","description":"Antibody identification; platelet associated immunoglobulin assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61316","name":"Inc&subq plmt crnl bone grf","description":"Incision and subcutaneous placement of cranial bone graft (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41006","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51597","name":"Removal of pelvic structures","description":"Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61650","name":"Evasc prlng admn rx agnt 1st","description":"Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36584","name":"Compl rplcmt picc rs&i","description":"Replacement, complete, of a peripherally inserted central venous catheter (picc), without subcutaneous port or pump, through same venous access, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3222","name":"Mens shoes hightop depth inl","description":"Orthopedic footwear, mens shoe, hightop, depth inlay, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99449","name":"Ntrprof ph1/ntrnet/ehr 31/>","description":"Interprofessional telephone/internet/electronic health record assessment and management service provided by a consultative physician or other qualified health care professional, including a verbal and written report to the patients treating/requesting physician or other qualified health care profess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31652","name":"Bronch ebus samplng 1/2 node","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83520","name":"Immunoassay quant nos nonab","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87906","name":"Nfct agt gntyp alys hiv1","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, other region (eg, integrase, fusion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"13121","name":"Cmplx rpr s/a/l 2.6-7.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60520","name":"Removal of thymus gland","description":"Thymectomy, partial or total; transcervical approach (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21082","name":"Impres&prep paltl aug prosth","description":"Impression and custom preparation; palatal augmentation prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35112","name":"Repair artery rupture spleen","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99157","name":"Mod sed other phys/qhp ea","description":"Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intraservice time (list separate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92012","name":"Intrm oph exam est patient","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4383.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4803.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92590","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55874","name":"Tprnl plmt biodegrdabl matrl","description":"Transperineal placement of biodegradable material, peri-prostatic, single or multiple injection(s), including image guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95713","name":"Veeg 2-12 hr cont mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54411","name":"Remov/replc penis pros comp","description":"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24151","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37197","name":"Remove intrvas foreign body","description":"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54500","name":"Biopsy of testis","description":"Biopsy of testis, needle (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0452","name":"Molecular pathology interpr","description":"Molecular pathology procedure; physician interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93041","name":"Rhythm ecg tracing","description":"Rhythm ecg, 1-3 leads; tracing only without interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44207","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0548T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64490","name":"Inj paravert f jnt c/t 1 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; single level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43200","name":"Esophagoscopy flexible brush","description":"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92004","name":"Compre oph exam new pt 1/>","description":"Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94668","name":"Mnpj chest wall sbsq","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55500","name":"Removal of hydrocele","description":"Excision of hydrocele of spermatic cord, unilateral (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50694","name":"Plmt ureteral stent prq","description":"Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; new access, without separate nephrostomy catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54450","name":"Preputial stretching","description":"Foreskin manipulation including lysis of preputial adhesions and stretching","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69610","name":"Tympanic membrane repair","description":"Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96127","name":"Brief emotional/behav assmt","description":"Brief emotional/behavioral assessment (eg, depression inventory, attention-deficit/hyperactivity disorder [adhd] scale), with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17261","name":"Dstrj mal les t/a/l .6-1.0cm","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93282","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead transvenous implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94762","name":"N-invas ear/pls oximtry cont","description":"Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30520","name":"Repair of nasal septum","description":"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97010","name":"Hot or cold packs therapy","description":"Application of a modality to 1 or more areas; hot or cold packs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29823","name":"Sho arthrs srg xtnsv dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the ro","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53446","name":"Remove uro sphincter","description":"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27405","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; collateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24101","name":"Arthrt elbw jt expl bx rmvl","description":"Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83520","name":"Immunoassay quant nos nonab","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2201.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27501","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53620","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87904","name":"Phenotype dna hiv w/clt add","description":"Infectious agent phenotype analysis by nucleic acid (dna or rna) with drug resistance tissue culture analysis, hiv 1; each additional drug tested (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4989","name":"Contracept iud","description":"Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21230","name":"Rib cartilage graft","description":"Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36569","name":"Insj picc 5 yr+ w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; age 5 years or older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24305","name":"Tendon lngth upr a/e ea tdn","description":"Tendon lengthening, upper arm or elbow, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35702","name":"Expl n/flwd surg uxtr art","description":"Exploration not followed by surgical repair, artery; upper extremity (eg, axillary, brachial, radial, ulnar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53420","name":"Reconstruct urethra stage 1","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91105","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27562","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88371","name":"Protein western blot tissue","description":"Protein analysis of tissue by western blot, with interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2756.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22868","name":"Insj stablj dev w/dcmprn","description":"Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2466.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86689","name":"Htlv/hiv confirmj antibody","description":"Antibody; htlv or hiv antibody, confirmatory test (eg, western blot)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29583","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33368","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88271","name":"Cytogenetics dna probe","description":"Molecular cytogenetics; dna probe, each (eg, fish)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94727","name":"Gas dil/wshot deter lng vol","description":"Gas dilution or washout for determination of lung volumes and, when performed, distribution of ventilation and closing volumes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24666","name":"Optx radial head/nck fx rplc","description":"Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9685","name":"Acute nursing facility care","description":"Physician service or other qualified health care professional for the evaluation and management of a beneficiarys acute change in condition in a nursing facility. this service is for a demonstration project","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29886","name":"Arthrs knee surg drlg od les","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83015","name":"Heavy metal qual any number","description":"Heavy metal (eg, antimony, arsenic, barium, beryllium, bismuth, gadolinium, mercury); qualitative, any number of analytes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82943","name":"Assay of glucagon","description":"Glucagon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86386","name":"Nuclear matrix protein 22","description":"Nuclear matrix protein 22 (nmp22), qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31575","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, flexible; diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78465","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92987","name":"Revision of mitral valve","description":"Percutaneous balloon valvuloplasty; mitral valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20606","name":"Drain/inj joint/bursa w/us","description":"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31653","name":"Bronch ebus samplng 3/> node","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]), 3 or more mediastinal and/or hilar lymph node stations or structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25622","name":"Cltx carpl scphd fx w/o mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27762","name":"Cltx med ankle fx w/mnpj","description":"Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41825","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94780","name":"Cars/bd tst inft-12mo 60 min","description":"Car seat/bed testing for airway integrity, for infants through 12 months of age, with continual clinical staff observation and continuous recording of pulse oximetry, heart rate and respiratory rate, with interpretation and report; 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84681","name":"Assay of c-peptide","description":"C-peptide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76140","name":"X-ray consultation","description":"Consultation on x-ray examination made elsewhere, written report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4040.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57240","name":"Anterior colporrhaphy","description":"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22521","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4806.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0421","name":"Ed svc ckd grp per session","description":"Face-to-face educational services related to the care of chronic kidney disease; group, per session, per one hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62305","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12035","name":"Intmd rpr s/a/t/ext 12.6-20","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15828","name":"Rhytidectomy cheek chn & nck","description":"Rhytidectomy; cheek, chin, and neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4040.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4627","name":"Spacer bag/reservoir","description":"Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25150","name":"Partial removal of ulna","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21616","name":"Exc 1st&/crv rib w/sympth","description":"Excision first and/or cervical rib; with sympathectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2301.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90862","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52285","name":"Cystoscopy and treatment","description":"Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6020.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21555","name":"Exc neck les sc < 3 cm","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92920","name":"Prq trluml c angiop 1art&/br","description":"Percutaneous transluminal coronary angioplasty, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90466","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65870","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); anterior synechiae, except goniosynechiae","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26080","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31592","name":"Cricotracheal resection","description":"Cricotracheal resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81164","name":"Brca1&2 gen ful dup/del alys","description":"Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full duplication/deletion analysis (ie, detection of large gene rearrangements)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6296.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11283.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75662","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96375","name":"Tx/pro/dx inj new drug addon","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72158","name":"Mri lumbar spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84704","name":"Hcg free betachain test","description":"Gonadotropin, chorionic (hcg); free beta chain","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26123","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0075","name":"Transport port x-ray multipl","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26863","name":"Fuse/graft added joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft), each additional joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26706","name":"Pin knuckle dislocation","description":"Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35473","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49014","name":"Reexploration pelvic wound","description":"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25112","name":"Reremove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); recurrent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62263","name":"Epidural lysis mult sessions","description":"Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic saline, enzyme) or mechanical means (eg, catheter) including radiologic localization (includes contrast when administered), multiple adhesiolysis sessions; 2 or more days","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36227","name":"Place cath xtrnl carotid","description":"Selective catheter placement, external carotid artery, unilateral, with angiography of the ipsilateral external carotid circulation and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32674","name":"Thoracoscopy lymph node exc","description":"Thoracoscopy, surgical; with mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21335","name":"Open tx nose & septal fx","description":"Open treatment of nasal fracture; with concomitant open treatment of fractured septum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5008","name":"Hearing screening","description":"Hearing screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46947","name":"Hemorrhoidopexy by stapling","description":"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4110.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0506","name":"Comp asses care plan ccm svc","description":"Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0278","name":"Iliac art angio,cardiac cath","description":"Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, inj","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"62323","name":"Njx interlaminar lmbr/sac","description":"Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluorosc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93272","name":"Ecg/review interpret only","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63001","name":"Remove spine lamina 1/2 crvl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4290","name":"Sacral nerve stim test lead","description":"Sacral nerve stimulation test lead, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4808.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34813","name":"Femoral endovas graft add-on","description":"Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67950","name":"Revision of eyelid","description":"Canthoplasty (reconstruction of canthus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21742","name":"Repair stern/nuss w/o scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), without thoracoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0443T","name":"R-t spctrl alys prst8 tiss","description":"Real-time spectral analysis of prostate tissue by fluorescence spectroscopy, including imaging guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62140","name":"Crnop skull defect<5 cm diam","description":"Cranioplasty for skull defect; up to 5 cm diameter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95973","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61630","name":"Balo angioplasty icr perq","description":"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2087","name":"Off base opioid tx, 60 m","description":"Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; at least 60 minutes in a subsequent calendar month","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36478","name":"Endovenous laser 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49185","name":"Sclerotx fluid collection","description":"Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21800","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0213T","name":"Njx paravert w/us cer/thor","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with ultrasound guidance, cervical or thoracic; single level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33612","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair; with repair of right ventricular outflow tract obstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28260","name":"Release of midfoot joint","description":"Capsulotomy, midfoot; medial release only (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31592","name":"Cricotracheal resection","description":"Cricotracheal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27725","name":"Repair of lower leg","description":"Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68340","name":"Separate eyelid adhesions","description":"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33956","name":"Ecmo/ecls insj ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, 6 years and older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0150T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61601","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28570","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4801.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27700","name":"Revision of ankle joint","description":"Arthroplasty, ankle;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31367","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, without radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32150","name":"Removal of lung lesion(s)","description":"Thoracotomy; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S3818","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33786","name":"Repair arterial trunk","description":"Total repair, truncus arteriosus (rastelli type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6228","name":"Gauze <= 16 sq in water/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20950","name":"Mntr intrstitial fluid press","description":"Monitoring of interstitial fluid pressure (includes insertion of device, eg, wick catheter technique, needle manometer technique) in detection of muscle compartment syndrome","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61782","name":"Scan proc cranial extra","description":"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84160","name":"Assay of protein any source","description":"Protein, total, by refractometry, any source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54001","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20101","name":"Expl pentrg wound chest","description":"Exploration of penetrating wound (separate procedure); chest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95071","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3292.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95966","name":"Meg evoked single","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, single modality (eg, sensory, motor, language, or visual cortex localization)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37234","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1942.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"41530","name":"Tongue base vol reduction","description":"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48001","name":"Placement of drain pancreas","description":"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33964","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37207","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3010.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27235","name":"Treat thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, proximal end, neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22216","name":"Incis addl spine segment","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11839.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61623","name":"Evasc temp balo artl occ h/n","description":"Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiogra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87305","name":"Aspergillus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; aspergillus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93287","name":"Peri-px device eval & prgr","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66680","name":"Repair iris & ciliary body","description":"Repair of iris, ciliary body (as for iridodialysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47544","name":"Removal duct glbldr calculi","description":"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (list sep","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0485T","name":"Oct mid ear i&r unilateral","description":"Optical coherence tomography (oct) of middle ear, with interpretation and report; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28292","name":"Cor hlx vlgs rsc prx phlx bs","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74330","name":"X-ray bile/panc endoscopy","description":"Combined endoscopic catheterization of the biliary and pancreatic ductal systems, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32035","name":"Thoracostomy w/rib resection","description":"Thoracostomy; with rib resection for empyema","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61612","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93297","name":"Rem interrog dev eval icpms","description":"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other quali","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44137","name":"Remove intestinal allograft","description":"Removal of transplanted intestinal allograft, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3203","name":"Oxford w/ supinator/pronator","description":"Orthopedic shoe, oxford with supinator or pronator, junior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43239","name":"Egd biopsy single/multiple","description":"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64508","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10737.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75724","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41116","name":"Excision of mouth lesion","description":"Excision, lesion of floor of mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63044","name":"Laminotomy addl lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional lumbar interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27438","name":"Revise kneecap with implant","description":"Arthroplasty, patella; with prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26765","name":"Treat finger fracture each","description":"Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92517","name":"Vemp test i&r cervical","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10008","name":"Fna bx w/fluor gdn ea addl","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3375.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3656.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86336","name":"Inhibin a","description":"Inhibin a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61612","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90836","name":"Psytx w pt w e/m 45 min","description":"Psychotherapy, 45 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93668","name":"Peripheral vascular rehab","description":"Peripheral arterial disease (pad) rehabilitation, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75961","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4529","name":"Ped size brief/diaper sm/med","description":"Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25525","name":"Optx rdl shft fx&cltx rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes percutaneous skeletal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49061","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64479","name":"Njx aa&/strd tfrm epi c/t 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, single level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"41130","name":"Partial removal of tongue","description":"Glossectomy; hemiglossectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69644","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33840","name":"Exc coa w/direct anastomosis","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with direct anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19125","name":"Excision breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27888","name":"Amputation of foot at ankle","description":"Amputation, ankle, through malleoli of tibia and fibula (eg, syme, pirogoff type procedures), with plastic closure and resection of nerves","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25120","name":"Removal of forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45113","name":"Partial proctectomy","description":"Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (s or j), with or without loop ileostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96170","name":"Hlth bhv ivntj fam wo pt 1st","description":"Health behavior intervention, family (without the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4657","name":"Syringe w/wo needle","description":"Syringe, with or without needle, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87512","name":"Gardner vag dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32672","name":"Thoracoscopy for lvrs","description":"Thoracoscopy, surgical; with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction (lvrs), unilateral includes any pleural procedure, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"60512","name":"Autotransplant parathyroid","description":"Parathyroid autotransplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64463","name":"Pvb thoracic cont infusion","description":"Paravertebral block (pvb) (paraspinous block), thoracic; continuous infusion by catheter (includes imaging guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65280","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49442","name":"Place cecostomy tube perc","description":"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12034","name":"Intmd rpr s/tr/ext 7.6-12.5","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35600","name":"Open hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27138","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; femoral component only, with or without allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35476","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21340","name":"Perq tx nasoethmoid fx","description":"Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50300","name":"Remove cadaver donor kidney","description":"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84228","name":"Assay of quinine","description":"Quinine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87563","name":"M. genitalium amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma genitalium, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2609","name":"Custom fabricate w/c cushion","description":"Custom fabricated wheelchair seat cushion, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99404","name":"Prev med cnsl indiv apprx 60","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81179","name":"Atxn2 gene detc abnor allele","description":"Atxn2 (ataxin 2) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64446","name":"Njx aa&/strd sc nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; sciatic nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47143","name":"Prep donor liver whole","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; without triseg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66720","name":"Destruction ciliary body","description":"Ciliary body destruction; cryotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61710","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51700","name":"Irrigation of bladder","description":"Bladder irrigation, simple, lavage and/or instillation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67414","name":"Explr/decompress eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87555","name":"M.tuberculo dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21335","name":"Open tx nose & septal fx","description":"Open treatment of nasal fracture; with concomitant open treatment of fractured septum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35583","name":"Vein byp grft fem-popliteal","description":"In-situ vein bypass; femoral-popliteal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58674","name":"Laps abltj uterine fibroids","description":"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4490","name":"Above knee surgical stocking","description":"Surgical stockings above knee length, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"11422","name":"Exc h-f-nk-sp b9+marg 1.1-2","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33237","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35241","name":"Rpr blvsl vn grf ntrthrc w/b","description":"Repair blood vessel with vein graft; intrathoracic, with bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28008","name":"Incision of foot fascia","description":"Fasciotomy, foot and/or toe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93291","name":"Interrog dev eval scrms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; subcutaneous cardiac rhythm monitor system, including heart rhythm derived data analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0581T","name":"Abltj mal brst tum perq crtx","description":"Ablation, malignant breast tumor(s), percutaneous, cryotherapy, including imaging guidance when performed, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25028","name":"I&d f/arm&/wrst dp absc/hmtm","description":"Incision and drainage, forearm and/or wrist; deep abscess or hematoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27306","name":"Incision of thigh tendon","description":"Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82106","name":"Alpha-fetoprotein amniotic","description":"Alpha-fetoprotein (afp); amniotic fluid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77079","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61703","name":"Clamp neck artery","description":"Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (selverstone-crutchfield type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1238.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5947.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96415","name":"Chemo iv infusion addl hr","description":"Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87810","name":"Chlmyd trach assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; chlamydia trachomatis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"52648","name":"Laser surgery of prostate","description":"Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0275T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21198","name":"Reconstr lwr jaw segment","description":"Osteotomy, mandible, segmental;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33332","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55880","name":"Abltj mal prst8 tiss hifu","description":"Ablation of malignant prostate tissue, transrectal, with high intensity-focused ultrasound (hifu), including ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3212","name":"Benesch boot pair infant","description":"Benesch boot, pair, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81002","name":"Urinalysis nonauto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84182","name":"Protein western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid, immunological probe for band identification, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64581","name":"Opn impltj nea sacral nerve","description":"Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21016","name":"Resect face/scalp tum 2 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; 2 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0013A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22327","name":"Treat thorax spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47147","name":"Prep donor liver/arterial","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8450.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28307","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78460","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21085","name":"Impres&prep oral surg splint","description":"Impression and custom preparation; oral surgical splint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36570","name":"Insert picvad cath","description":"Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5037.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29881","name":"Arthrs kne srg mnisectmy m/l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50574","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34716","name":"Opn ax/subcla art expos cndt","description":"Open axillary/subclavian artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4246","name":"Betadine/phisohex solution","description":"Betadine or phisohex solution, per pint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2010","name":"Remot image submit by pt","description":"Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m ser","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62165","name":"Remove pituit tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63308","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (list separately in addition to codes for single segment)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90952","name":"Esrd serv 2-3 vsts p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professio","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84146","name":"Assay of prolactin","description":"Prolactin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25360","name":"Revision of ulna","description":"Osteotomy; ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57022","name":"I&d vaginal hematoma ob/pp","description":"Incision and drainage of vaginal hematoma; obstetrical/postpartum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35540","name":"Art byp grft aortbifemoral","description":"Bypass graft, with vein; aortobifemoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00528","name":"Anes clsd ch mediast&thrc wo","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing 1 lung ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75671","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91300","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93298","name":"Rem interrog dev eval scrms","description":"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33522","name":"Cabg artery-vein five","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 5 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90865","name":"Narcosynthesis","description":"Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (amytal) interview)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64874","name":"Repair & revise nerve add-on","description":"Suture of nerve; requiring extensive mobilization, or transposition of nerve (list separately in addition to code for nerve suture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15572","name":"Skin pedicle flap arms/legs","description":"Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19298","name":"Place breast rad tube/caths","description":"Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83722","name":"Lipoprtn dir meas sd ldl chl","description":"Lipoprotein, direct measurement; small dense ldl cholesterol","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42107","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with local flap closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35535","name":"Art byp grft hepatorenal","description":"Bypass graft, with vein; hepatorenal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1684.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30118","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25560","name":"Cltx rdl&uln shft fx wo mnpj","description":"Closed treatment of radial and ulnar shaft fractures; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20924","name":"Removal of tendon for graft","description":"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6205","name":"Composite drsg > 48 sq in","description":"Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99496","name":"Transj care mgmt high f2f 7d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge high level of medical decision making during the service period face-to-face visit, within 7 calenda","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21081","name":"Impres&prep mndbl res prosth","description":"Impression and custom preparation; mandibular resection prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41140","name":"Removal of tongue","description":"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49460","name":"Fix g/colon tube w/device","description":"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including contrast injection(s), if performed, image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47552","name":"Biliary endo perq dx w/speci","description":"Biliary endoscopy, percutaneous via t-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33250","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36583","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11103","name":"Tangntl bx skin ea sep/addl","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86807","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); standard method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85525","name":"Heparin neutralization","description":"Heparin neutralization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43258","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61215","name":"Ins subq rsvr pmp/nfs sys","description":"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59320","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; vaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58544","name":"Lsh w/t/o uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64626","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50328","name":"Prep renal graft/arterial","description":"Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52317","name":"Remove bladder stone","description":"Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87485","name":"Chlmyd pneum dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78708","name":"K flow/funct image w/drug","description":"Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27372","name":"Removal of foreign body","description":"Removal of foreign body, deep, thigh region or knee area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77078","name":"Ct bone density axial","description":"Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27246","name":"Treat thigh fracture","description":"Closed treatment of greater trochanteric fracture, without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2013","name":"Post-d/c h vst ext pt 75 m","description":"Extensive (75 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient fa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6412","name":"Occlusive eye patch","description":"Eye patch, occlusive, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1901","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50394","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0761","name":"Nontherm electromgntc device","description":"Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4244","name":"Alcohol or peroxide per pint","description":"Alcohol or peroxide, per pint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45308","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65210","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62319","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0324","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61641","name":"Dilat ic vspsm ea vsl sm ter","description":"Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60650","name":"Laparoscopy adrenalectomy","description":"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1982.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0086","name":"Care man home care plan 30 m","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["AW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27619","name":"Exc leg/ankle tum deep <5 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96934","name":"Rcm img acquisj&i&r ea addl","description":"Reflectance confocal microscopy (rcm) for cellular and sub-cellular imaging of skin; image acquisition and interpretation and report, each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65135","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58280","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47146","name":"Prep donor liver/venous","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99177","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98962","name":"Edu&trn pt slf-mgmt nqhp 5-8","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 5-8 patients","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31201","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61533","name":"Implant brain electrodes","description":"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4212","name":"Non coring needle or stylet","description":"Non-coring needle or stylet with or without catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P3000","name":"Screen pap by tech w md supv","description":"Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99472","name":"Ped critical care subsq","description":"Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35002","name":"Repair artery rupture neck","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, carotid, subclavian artery, by neck incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11004","name":"Dbrdmt skin xtrnl gent&per","description":"Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97530","name":"Therapeutic activities","description":"Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91301","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99253","name":"Ip/obs cnsltj new/est low 45","description":"Inpatient or observation consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15839","name":"Exc excessive skn other area","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43845","name":"Gastroplasty duodenal switch","description":"Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0480T","name":"Fxjl abl lsr ea addl 100sqcm","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; each additional 100 cm2, or each additional 1% of body surface area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77432","name":"Stereotactic radiation trmt","description":"Stereotactic radiation treatment management of cranial lesion(s) (complete course of treatment consisting of 1 session)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3909","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86707","name":"Hepatitis be antibody","description":"Hepatitis be antibody (hbeab)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21813","name":"Treatment of rib fracture","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65760","name":"Keratomileusis","description":"Keratomileusis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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","AV","AU","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0087","name":"Care man home care plan 60 m","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61790","name":"Treat trigeminal nerve","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51841","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); complicated (eg, secondary repair)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87511","name":"Gardner vag dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31612","name":"Perq trchl pnxr ttrach aspir","description":"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1753","name":"Cath, intravas ultrasound","description":"Catheter, intravascular ultrasound","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28122","name":"Partial removal of foot bone","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28107","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96423","name":"Chemo ia infuse each addl hr","description":"Chemotherapy administration, intra-arterial; infusion technique, each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93244","name":"Ext ecg>48hr<7d rev&interpj","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32557","name":"Insert cath pleura w/ image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54520","name":"Removal of testis","description":"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89325","name":"Sperm antibody test","description":"Sperm antibodies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67312","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 horizontal muscles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87625","name":"Hpv types 16 & 18 only","description":"Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), types 16 and 18 only, includes type 45, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28230","name":"Incision of foot tendon(s)","description":"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20694","name":"Rmvl ext fixj sys under anes","description":"Removal, under anesthesia, of external fixation system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1206","name":"Topical fluoride varnish","description":"Topical fluoride varnish; therapeutic application for moderate to high caries risk patients","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94013","name":"Meas lung vol thru 2 yrs","description":"Measurement of lung volumes (ie, functional residual capacity [frc], forced vital capacity [fvc], and expiratory reserve volume [erv]) in an infant or child through 2 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27323","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3005.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86732","name":"Mucormycosis antibody","description":"Antibody; mucormycosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87299","name":"Antibody detection nos if","description":"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64412","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3201","name":"Oxford w supinat/pronat inf","description":"Orthopedic shoe, oxford with supinator or pronator, infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49572","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64857","name":"Repair arm/leg nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35131","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery (common, hypogastric, external)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21550","name":"Biopsy of neck/chest","description":"Biopsy, soft tissue of neck or thorax","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01936","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92313","name":"C-lens fitg corneosclrl lens","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscleral lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0249","name":"Provide inr test mater/equip","description":"Provision of test materials and equipment for home inr monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44401","name":"Colonoscopy with ablation","description":"Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2175.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31528","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33335","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99468","name":"Neonate crit care initial","description":"Initial inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8645.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0453","name":"Cont intraop neuro monitor","description":"Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97032","name":"Appl modality 1+estim ea 15","description":"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15336","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83722","name":"Lipoprtn dir meas sd ldl chl","description":"Lipoprotein, direct measurement; small dense ldl cholesterol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G9481","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history;  a problem focused examination; and straightforward medical decision making, furn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61250","name":"Burr hole/treph sttl expl","description":"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15157","name":"Tis clt agrft f/s/n/h/f/g ea","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22840","name":"Insert spine fixation device","description":"Posterior non-segmental instrumentation (eg, harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at c1, facet screw fixation) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58661","name":"Laparoscopy remove adnexa","description":"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58563","name":"Hysteroscopy ablation","description":"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29305","name":"Appl hip spica cast 1 leg","description":"Application of hip spica cast; 1 leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35500","name":"Harvest vein for bypass","description":"Harvest of upper extremity vein, 1 segment, for lower extremity or coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11900.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25391","name":"Lengthen radius or ulna","description":"Osteoplasty, radius or ulna; lengthening with autograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39501","name":"Repair diaphragm laceration","description":"Repair, laceration of diaphragm, any approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27894","name":"Decompression of leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99291","name":"Critical care first hour","description":"Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44970","name":"Laparoscopy appendectomy","description":"Laparoscopy, surgical, appendectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27860","name":"Fixation of ankle joint","description":"Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63275","name":"Bx/exc xdrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87430","name":"Strep a ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; streptococcus, group a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26020","name":"Drain hand tendon sheath","description":"Drainage of tendon sheath, digit and/or palm, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4755","name":"Comb art/venous blood tubing","description":"Blood tubing, arterial and venous combined, for hemodialysis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44705","name":"Prepare fecal microbiota","description":"Preparation of fecal microbiota for instillation, including assessment of donor specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69436","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33523","name":"Cabg art-vein six or more","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0475","name":"Hiv combination assay","description":"Hiv antigen/antibody, combination assay, screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85293","name":"Clot factor wght kininogen","description":"Clotting; high molecular weight kininogen assay (fitzgerald factor assay)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63308","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (list separately in addition to codes for single segment)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67320","name":"Revise eye muscle(s) add-on","description":"Transposition procedure (eg, for paretic extraocular muscle), any extraocular muscle (specify) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2358","name":"Gr 34 nonsealed leadacid","description":"Power wheelchair accessory, group 34 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20938","name":"Sp bone agrft struct add-on","description":"Autograft for spine surgery only (includes harvesting the graft); structural, bicortical or tricortical (through separate skin or fascial incision) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44386","name":"Endoscopy bowel pouch/biop","description":"Endoscopic evaluation of small intestinal pouch (eg, kock pouch, ileal reservoir [s or j]); with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31087","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41010","name":"Incision of tongue fold","description":"Incision of lingual frenum (frenotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63741","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35691","name":"Art trnsposj vertbrl carotid","description":"Transposition and/or reimplantation; vertebral to carotid artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61796","name":"Srs cranial lesion simple","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20950","name":"Mntr intrstitial fluid press","description":"Monitoring of interstitial fluid pressure (includes insertion of device, eg, wick catheter technique, needle manometer technique) in detection of muscle compartment syndrome","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38531","name":"Open bx/exc inguinofem nodes","description":"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41820","name":"Excision gum each quadrant","description":"Gingivectomy, excision gingiva, each quadrant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67107","name":"Repair detached retina","description":"Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41520","name":"Reconstruction tongue fold","description":"Frenoplasty (surgical revision of frenum, eg, with z-plasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43324","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64420","name":"Njx aa&/strd ntrcost nrv 1","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65125","name":"Revise ocular implant","description":"Modification of ocular implant with placement or replacement of pegs (eg, drilling receptacle for prosthesis appendage) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26145","name":"Tendon excision palm/finger","description":"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0289","name":"Arthro, loose body + chondro","description":"Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64421","name":"Njx aa&/strd ntrcost nrv ea","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, each additional level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43100","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; cervical approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15941","name":"Exc isch pr ulc prm sut ostc","description":"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27658","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6228","name":"Gauze <= 16 sq in water/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8699.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10071.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29720","name":"Repair spica body cst/jacket","description":"Repair of spica, body cast or jacket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83664","name":"Lamellar bdy fetal lung","description":"Fetal lung maturity assessment; lamellar body density","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38520","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"56634","name":"Vlvctmy rad comp uni lymphad","description":"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31572","name":"Largsc w/laser dstrj les","description":"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36597","name":"Reposition venous catheter","description":"Repositioning of previously placed central venous catheter under fluoroscopic guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4212","name":"Non coring needle or stylet","description":"Non-coring needle or stylet with or without catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50557","name":"Kidney endoscopy & treatment","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32505","name":"Wedge resect of lung initial","description":"Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27176","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43652","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33933","name":"Prepare donor heart/lung","description":"Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and trachea for implantation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27347","name":"Remove knee cyst","description":"Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69530","name":"Extensive mastoid surgery","description":"Petrous apicectomy including radical mastoidectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27552","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87797","name":"Detect agent nos dna dir","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; direct probe technique, each organism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58293","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27477","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94640","name":"Airway inhalation treatment","description":"Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure breathing (ippb) device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96103","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31626","name":"Bronchoscopy w/markers","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of fiducial markers, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50820","name":"Construct bowel bladder","description":"Ureteroileal conduit (ileal bladder), including intestine anastomosis (bricker operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47490","name":"Incision of gallbladder","description":"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27043","name":"Exc hip pelvis les sc 3 cm/>","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38211","name":"Tumor cell deplete of harvst","description":"Transplant preparation of hematopoietic progenitor cells; tumor cell depletion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33249","name":"Insj/rplcmt defib w/lead(s)","description":"Insertion or replacement of permanent implantable defibrillator system, with transvenous lead(s), single or dual chamber","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82654","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87635","name":"Sars-cov-2 covid-19 amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72157","name":"Mri chest spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26480","name":"Transplant hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35281","name":"Rpr blvsl gr ot/th vn ntr-ab","description":"Repair blood vessel with graft other than vein; intra-abdominal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21073","name":"Mnpj of tmj w/anesth","description":"Manipulation of temporomandibular joint(s) (tmj), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28600","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24065","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4479","name":"Transanal irrigation, electr","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32906","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages); with closure of bronchopleural fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36224","name":"Place cath carotd art","description":"Selective catheter placement, internal carotid artery, unilateral, with angiography of the ipsilateral intracranial carotid circulation and all associated radiological supervision and interpretation, includes angiography of the extracranial carotid and cervicocerebral arch, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62120","name":"Repair skull cavity lesion","description":"Repair of encephalocele, skull vault, including cranioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0341","name":"Percutaneous islet celltrans","description":"Percutaneous islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23472","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0144T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51535","name":"Repair of ureter lesion","description":"Cystotomy for excision, incision, or repair of ureterocele","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51710","name":"Change of bladder tube","description":"Change of cystostomy tube; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76536","name":"Us exam of head and neck","description":"Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33958","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27652","name":"Repair/graft achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon; with graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60280","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23575","name":"Cltx scap fx w/mnpj +-tractj","description":"Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvement)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66505","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6118.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0147T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61105","name":"Tdh sdrl/ventr pnxr","description":"Twist drill hole for subdural or ventricular puncture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92970","name":"Cardioassist internal","description":"Cardioassist-method of circulatory assist; internal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78709","name":"K flow/funct image multiple","description":"Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological intervention (eg, angiotensin converting enzyme inhibitor and/or diuretic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28476","name":"Prq skel fix metar fx w/mnpj","description":"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49421","name":"Ins tun ip cath for dial opn","description":"Insertion of tunneled intraperitoneal catheter for dialysis, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2321.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80076","name":"Hepatic function panel","description":"Hepatic function panel this panel must include the following: albumin (82040) bilirubin, total (82247) bilirubin, direct (82248) phosphatase, alkaline (84075) protein, total (84155) transferase, alanine amino (alt) (sgpt) (84460) transferase, aspartate amino (ast) (sgot) (84450)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93642","name":"Ep evl 1/2chmb trnsvns cvdfb","description":"Electrophysiologic evaluation of single or dual chamber transvenous pacing cardioverter-defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4160","name":"Ef ped caloric dense>/=0.7kc","description":"Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11760","name":"Repair of nail bed","description":"Repair of nail bed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93508","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78830","name":"Rp loclzj tum spect w/ct 1","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37217","name":"Stent placemt retro carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87164","name":"Dark field exam spec collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36557","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87582","name":"M.pneumon dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4105","name":"Enzyme cartridge enteral nut","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29510.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43755","name":"Dx gastr intub w/asp specs","description":"Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium, secretin), includes drug administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50974","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57460","name":"Bx of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63655","name":"Implant neuroelectrodes","description":"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12046","name":"Intmd rpr n-hf/genit20.1-30","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64489","name":"Tap block bi by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33251","name":"Ablate heart dysrhythm focus","description":"Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, wolff-parkinson-white, atrioventricular node re-entry), tract(s) and/or focus (foci); with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47146","name":"Prep donor liver/venous","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27198","name":"Clsd tx pelvic ring fx","description":"Closed treatment of posterior pelvic ring fracture(s), dislocation(s), diastasis or subluxation of the ilium, sacroiliac joint, and/or sacrum, with or without anterior pelvic ring fracture(s) and/or dislocation(s) of the pubic symphysis and/or superior/inferior rami, unilateral or bilateral; with ma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64623","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0512","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36590","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65140","name":"Attach ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles attached to implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22216","name":"Incis addl spine segment","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93922","name":"Upr/l xtremity art 2 levels","description":"Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, doppler waveform recording and analysis at 1-2 levels, or ankle/brachial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87807","name":"Rsv assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90885","name":"Psy evaluation of records","description":"Psychiatric evaluation of hospital records, other psychiatric reports, psychometric and/or projective tests, and other accumulated data for medical diagnostic purposes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64718","name":"Revise ulnar nerve at elbow","description":"Neuroplasty and/or transposition; ulnar nerve at elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12044","name":"Intmd rpr n-hf/genit7.6-12.5","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80438","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 1 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 3)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50234","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through same incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53431","name":"Reconstruct urethra/bladder","description":"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, tenago, leadbetter procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9040","name":"Rbc leukoreduced irradiated","description":"Red blood cells, leukocytes reduced, irradiated, each unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50725","name":"Release/revise ureter","description":"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8999","name":"Resuscitation bag","description":"Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54440","name":"Repair of penis","description":"Plastic operation of penis for injury","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50387","name":"Change nephroureteral cath","description":"Removal and replacement of externally accessible nephroureteral catheter (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33615","name":"Repair modified fontan","description":"Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary artery (simple fontan procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70546","name":"Mr angiograph head w/o&w/dye","description":"Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"29220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27258","name":"Treat hip dislocation","description":"Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3202","name":"Oxford w/ supinat/pronator c","description":"Orthopedic shoe, oxford with supinator or pronator, child","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00792","name":"Anes iper upr abd prtl hptc","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53520","name":"Repair of urethra defect","description":"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84210","name":"Assay of pyruvate","description":"Pyruvate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58340","name":"Catheter for hysterography","description":"Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43647","name":"Lap impl electrode antrum","description":"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28455","name":"Tx tarsal b1 fx w/mnpj each","description":"Treatment of tarsal bone fracture (except talus and calcaneus); with manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19366","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44156","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with continent ileostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22854","name":"Insj biomechanical device","description":"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93294","name":"Rem interrog evl pm/ldls pm","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61545","name":"Excision of brain tumor","description":"Craniotomy with elevation of bone flap; for excision of craniopharyngioma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65815","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63287","name":"Bx/exc idrl imed lesn thrlmb","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8427","name":"Ready gradient glove","description":"Gradient pressure aid (glove), ready made","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15005","name":"Wnd prep f/n/hf/g addl cm","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0507","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46606","name":"Anoscopy and biopsy","description":"Anoscopy; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64896","name":"Nrv grf mltst hnd/foot >4 cm","description":"Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; more than 4 cm length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31573","name":"Largsc w/ther injection","description":"Laryngoscopy, flexible; with therapeutic injection(s) (eg, chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88375","name":"Optical endomicroscpy interp","description":"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45305","name":"Proctosigmoidoscopy w/bx","description":"Proctosigmoidoscopy, rigid; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74230","name":"X-ray xm swlng funcj c+","description":"Radiologic examination, swallowing function, with cineradiography/videoradiography, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31656","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15110","name":"Epidrm agrft t/a/l 1st 100","description":"Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51605","name":"Preparation for bladder xray","description":"Injection procedure and placement of chain for contrast and/or chain urethrocystography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35683","name":"Composite byp grft 3/> segmt","description":"Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more locations (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17274","name":"Dstr mal les s/n/h/f/g 3.1-4","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54065","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43246","name":"Egd place gastrostomy tube","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21137","name":"Rdctj forehead cntrg only","description":"Reduction forehead; contouring only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0316","name":"Prolong inpt eval add15 m","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28150","name":"Removal of toe","description":"Phalangectomy, toe, each toe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33217","name":"Insert 2 electrode pm-defib","description":"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4660","name":"Sphyg/bp app w cuff and stet","description":"Sphygmomanometer/blood pressure apparatus with cuff and stethoscope","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3173.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86813","name":"Hla typing a b or c","description":"Hla typing; a, b, or c, multiple antigens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93242","name":"Ext ecg>48hr<7d recording","description":"External electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; recording (includes connection and initial recording)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22534","name":"Arthrd lat xtrcvtry tq ea ad","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25335","name":"Centralization wrist on ulna","description":"Centralization of wrist on ulna (eg, radial club hand)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80074","name":"Acute hepatitis panel","description":"Acute hepatitis panel this panel must include the following: hepatitis a antibody (haab), igm antibody (86709) hepatitis b core antibody (hbcab), igm antibody (86705) hepatitis b surface antigen (hbsag) (87340) hepatitis c antibody (86803)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82610","name":"Cystatin c","description":"Cystatin c","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44128","name":"Enterectomy cong add-on","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4209","name":"5+ cc sterile syringe&needle","description":"Syringe with needle, sterile 5 cc or greater, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19364","name":"Brst rcnstj free flap","description":"Breast reconstruction; with free flap (eg, ftram, diep, siea, gap flap)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82308","name":"Assay of calcitonin","description":"Calcitonin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25441","name":"Arthrp w/prostc dstl rds","description":"Arthroplasty with prosthetic replacement; distal radius","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99231","name":"Sbsq hosp ip/obs sf/low 25","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date of the encounter for code selec","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64569","name":"Revise/repl vagus n eltrd","description":"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55821","name":"Removal of prostate","description":"Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73542","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27025","name":"Fasciotomy hip/thigh any typ","description":"Fasciotomy, hip or thigh, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44378","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4208","name":"3 cc sterile syringe&needle","description":"Syringe with needle, sterile 3 cc, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1300","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44378","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0467T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49420","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76498","name":"Unlisted mr procedure","description":"Unlisted magnetic resonance procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4247","name":"Betadine/iodine swabs/wipes","description":"Betadine or iodine swabs/wipes, per box","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53270","name":"Removal of urethra gland","description":"Excision or fulguration; skenes glands","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22010","name":"I&d p-spine c/t/cerv-thor","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33530","name":"Coronary artery bypass/reop","description":"Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7300.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96150","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99416","name":"Prolng clin staff svc ea add","description":"Prolonged clinical staff service (the service beyond the highest time in the range of total time of the service) during an evaluation and management service in the office or outpatient setting, direct patient contact with physician supervision; each additional 30 minutes (list separately in addition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99318","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64417","name":"Njx aa&/strd ax nerve img","description":"Injection(s), anesthetic agent(s) and/or steroid; axillary nerve, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4108.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1662.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87580","name":"M.pneumon dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15780","name":"Dermabrasion total face","description":"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T5001","name":"Position seat spec orth need","description":"Positioning seat for persons with special orthopedic needs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24126","name":"Exc/crtg b1 cst/tum rds algr","description":"Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process; with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10010","name":"Fna bx w/ct gdn ea addl","description":"Fine needle aspiration biopsy, including ct guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27216","name":"Treat pelvic ring fracture","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86235","name":"Nuclear antigen antibody","description":"Extractable nuclear antigen, antibody to, any method (eg, nrnp, ss-a, ss-b, sm, rnp, sc170, j01), each antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99342","name":"Home/res vst new low mdm 30","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12005","name":"Rpr s/n/a/gen/trk12.6-20.0cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97537","name":"Community/work reintegration","description":"Community/work reintegration training (eg, shopping, transportation, money management, avocational activities and/or work environment/modification analysis, work task analysis, use of assistive technology device/adaptive equipment), direct one-on-one contact, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0190T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3257","name":"Orth foot add charge split s","description":"Orthopedic footwear, additional charge for split size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27810","name":"Treatment of ankle fracture","description":"Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42825","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; younger than age 12","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0238T","name":"Trluml perip athrc iliac art","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78835","name":"Rp quan meas single area","description":"Radiopharmaceutical quantification measurement(s) single area (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31645","name":"Brnchsc w/ther aspir 1st","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"55865","name":"Extensive prostate surgery","description":"Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97166","name":"Ot eval mod complex 45 min","description":"Occupational therapy evaluation, moderate complexity, requiring these components: an occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current func","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46946","name":"Int hrhc lig 2+hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47543","name":"Endoluminal bx biliary tree","description":"Endoluminal biopsy(ies) of biliary tree, percutaneous, any method(s) (eg, brush, forceps, and/or needle), including imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation, single or multiple (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27077","name":"Resect hip tum w/innom bone","description":"Radical resection of tumor; innominate bone, total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9920","name":"Scrning perf and negative","description":"Screening performed and negative","date_of_service":"2026-06-06","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":["U1","U9"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63706","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; larger than 5 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90887","name":"Interpj/explnaj rslt psyc xm","description":"Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27035","name":"Denervation of hip joint","description":"Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of sciatic, femoral, or obturator nerves","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64569","name":"Revise/repl vagus n eltrd","description":"Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator electrode array, including connection to existing pulse generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93541","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","59"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45337","name":"Sigmoidoscopy & decompress","description":"Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31622","name":"Dx bronchoscope/wash","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29515","name":"Application short leg splint","description":"Application of short leg splint (calf to foot)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78451","name":"Ht muscle image spect sing","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87391","name":"Hiv-2 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-2","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8908","name":"Mri w/o fol w/cont, breast,","description":"Magnetic resonance imaging without contrast followed by with contrast, breast; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27331","name":"Explore/treat knee joint","description":"Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37224","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77522","name":"Proton trmt simple w/comp","description":"Proton treatment delivery; simple, with compensation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54865","name":"Explore epididymis","description":"Exploration of epididymis, with or without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97762","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36831","name":"Open thrombect av fistula","description":"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28045","name":"Exc foot/toe tum deep <1.5cm","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64633","name":"Destroy cerv/thor facet jnt","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, single facet joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96425","name":"Chemotherapy infusion method","description":"Chemotherapy administration, intra-arterial; infusion technique, initiation of prolonged infusion (more than 8 hours), requiring the use of a portable or implantable pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72081","name":"X-ray exam entire spi 1 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); one view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43121","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3875.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90804","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2032.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6118.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43274","name":"Ercp duct stent placement","description":"Endoscopic retrograde cholangiopancreatography (ercp); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01230","name":"Anes opn upper 2/3 femur nos","description":"Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["BA","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27619","name":"Exc leg/ankle tum deep <5 cm","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81333","name":"Tgfbi gene common variants","description":"Tgfbi (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, r124h, r124c, r124l, r555w, r555q)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86256","name":"Fluorescent antibody titer","description":"Fluorescent noninfectious agent antibody; titer, each antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86694","name":"Herpes simplex nes antbdy","description":"Antibody; herpes simplex, non-specific type test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"40761","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (abbe-estlander type), including sectioning and inserting of pedicle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81239","name":"Dmpk gene charac alleles","description":"Dmpk (dm1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00322","name":"Anes all px nck ndl bx thyr","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; needle biopsy of thyroid","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87510","name":"Gardner vag dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22524","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61615","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; extradural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75954","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90912","name":"Bfb training 1st 15 min","description":"Biofeedback training, perineal muscles, anorectal or urethral sphincter, including emg and/or manometry, when performed; initial 15 minutes of one-on-one physician or other qualified health care professional contact with the patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61320","name":"Crnec/crnot drg icr abs sttl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61536","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25805","name":"Arthrd wrist w/sliding graft","description":"Arthrodesis, wrist; with sliding graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3464.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0221T","name":"Plmt post facet implt lumb","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11755","name":"Biopsy nail unit","description":"Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31233","name":"Nsl/sins ndsc dx max sinusc","description":"Nasal/sinus endoscopy, diagnostic; with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1874","name":"Stent, coated/cov w/del sys","description":"Stent, coated/covered, with delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52327","name":"Cystoscopy inject material","description":"Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42405","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; incisional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0565T","name":"Autol cell implt adps hrvg","description":"Autologous cellular implant derived from adipose tissue for the treatment of osteoarthritis of the knees; tissue harvesting and cellular implant creation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43245","name":"Egd dilate stricture","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2780.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26755","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37619","name":"Ligation of inf vena cava","description":"Ligation of inferior vena cava","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81333","name":"Tgfbi gene common variants","description":"Tgfbi (transforming growth factor beta-induced) (eg, corneal dystrophy) gene analysis, common variants (eg, r124h, r124c, r124l, r555w, r555q)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58673","name":"Laparoscopy salpingostomy","description":"Laparoscopy, surgical; with salpingostomy (salpingoneostomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27238","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44312","name":"Revision of ileostomy","description":"Revision of ileostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57465","name":"Cam cervix uteri drg colp","description":"Computer-aided mapping of cervix uteri during colposcopy, including optical dynamic spectral imaging and algorithmic quantification of the acetowhitening effect (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24545","name":"Optx hum fx wo ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38102","name":"Removal of spleen total","description":"Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (list in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3524.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"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":"37210","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15835","name":"Exc excessive skin buttock","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99233","name":"Sbsq hosp ip/obs high 50","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 50 minutes m","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22852","name":"Remove spine fixation device","description":"Removal of posterior segmental instrumentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35390","name":"Reoperation carotid add-on","description":"Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86711","name":"John cunningham antibody","description":"Antibody; jc (john cunningham) virus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1049.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95782","name":"Polysom <6 yrs 4/> paramtrs","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24344","name":"Reconstruct elbow lat ligmnt","description":"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37218","name":"Stent placemt ante carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3532.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66605","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; with cyclectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3989.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93280","name":"Pm device progr eval dual","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0292","name":"Hosp bed var ht no sr w/matt","description":"Hospital bed, variable height, hi-lo, without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89230","name":"Collect sweat for test","description":"Sweat collection by iontophoresis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35303","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; popliteal artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2996.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27279","name":"Arthrd si jt plmt tartclr dv","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89330","name":"Evaluation cervical mucus","description":"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15002","name":"Wound prep trk/arm/leg","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21423","name":"Optx palatal/max fx comp","description":"Open treatment of palatal or maxillary fracture (lefort i type); complicated (comminuted or involving cranial nerve foramina), multiple approaches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93268","name":"Ecg record/review","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; includes transmission, review and interpretation by a physician or other qualified hea","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95887","name":"Musc tst done w/n tst nonext","description":"Needle electromyography, non-extremity (cranial nerve supplied or axial) muscle(s) done with nerve conduction, amplitude and latency/velocity study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74174","name":"Cta abd&plvs w/contrast","description":"Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0473T","name":"Reprgrmg io rta eltrd ra","description":"Device evaluation and interrogation of intraocular retinal electrode array (eg, retinal prosthesis), in person, including reprogramming and visual training, when performed, with review and report by a qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6198","name":"Alginate dressing > 48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27745","name":"Reinforce tibia","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49582","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58400","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93298","name":"Rem interrog dev eval scrms","description":"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43283","name":"Lap esoph lengthening","description":"Laparoscopy, surgical, esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27696","name":"Repair of ankle ligaments","description":"Repair, primary, disrupted ligament, ankle; both collateral ligaments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24066","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77408","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37186","name":"Sec art thrombectomy add-on","description":"Secondary percutaneous transluminal thrombectomy (eg, nonprimary mechanical, snare basket, suction technique), noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injections, provided in conjunction with a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15860","name":"Iv njx tst vasc flo flap/grf","description":"Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77318","name":"Brachytx isodose complex","description":"Brachytherapy isodose plan; complex (calculation[s] made from over 10 sources, or remote afterloading brachytherapy, over 12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93745","name":"Set-up cardiovert-defibrill","description":"Initial set-up and programming by a physician or other qualified health care professional of wearable cardioverter-defibrillator includes initial programming of system, establishing baseline electronic ecg, transmission of data to data repository, patient instruction in wearing system and patient re","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4491.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33745","name":"Tis cgen car anomal 1st shnt","description":"Transcatheter intracardiac shunt (tis) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54406","name":"Remove muti-comp penis pros","description":"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61735","name":"Incise skull/brain surgery","description":"Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) other than globus pallidus or thalamus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49082","name":"Abd paracentesis","description":"Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25545","name":"Optx ulnar shft fx int fixj","description":"Open treatment of ulnar shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2028.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28530","name":"Treat sesamoid bone fracture","description":"Closed treatment of sesamoid fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29035","name":"Appl body cast sho to hips","description":"Application of body cast, shoulder to hips;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46710","name":"Repr per/vag pouch sngl proc","description":"Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21246","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64632","name":"N block inj common digit","description":"Destruction by neurolytic agent; plantar common digital nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0523T","name":"Ntrapx c ffr w/3d funcjl map","description":"Intraprocedural coronary fractional flow reserve (ffr) with 3d functional mapping of color-coded ffr values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (list separately in addition to code ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92516","name":"Facial nerve function test","description":"Facial nerve function studies (eg, electroneuronography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15201","name":"Fth/gft fr trnk each addl","description":"Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77080","name":"Dxa bone density axial","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83670","name":"Assay of lap enzyme","description":"Leucine aminopeptidase (lap)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2396.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93247","name":"Ext ecg>7d<15d scan a/r","description":"External electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; scanning analysis with report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21044","name":"Removal of jaw bone lesion","description":"Excision of malignant tumor of mandible;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1063.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31577","name":"Largsc w/rmvl foreign bdy(s)","description":"Laryngoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2584.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81274","name":"Htt gene charac alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23625","name":"Cltx gr hmrl tbrs fx w/mnpj","description":"Closed treatment of greater humeral tuberosity fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20922","name":"Removal of fascia for graft","description":"Fascia lata graft; by incision and area exposure, complex or sheet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4860","name":"Disposable catheter tips","description":"Disposable catheter tips for peritoneal dialysis, per 10","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6391.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20979","name":"Lw ntsty us stimj bone healg","description":"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96156","name":"Hlth bhv assmt/reassessment","description":"Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60300","name":"Aspir/inj thyroid cyst","description":"Aspiration and/or injection, thyroid cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85396","name":"Clotting assay whole blood","description":"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92014","name":"Compre oph exam est pt 1/>","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44136","name":"Intestine transplant live","description":"Intestinal allotransplantation; from living donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61530","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22600","name":"Arthrd pst tq 1ntrspc crv","description":"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below c2 segment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11404","name":"Exc tr-ext b9+marg 3.1-4 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23585","name":"Optx scapular fx w/int fixj","description":"Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27075","name":"Resect hip tumor","description":"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59855","name":"Induced abortion 1+vag supp","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2148.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43259","name":"Egd us exam duodenum/jejunum","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43757","name":"Dx duod intub w/asp specs","description":"Duodenal intubation and aspiration, diagnostic, includes image guidance; collection of multiple fractional specimens with pancreatic or gallbladder stimulation, single or double lumen tube, includes drug administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61610","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26356","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); primary, without free graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47538","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; existing ac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3303.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29450","name":"Application clubfoot cast","description":"Application of clubfoot cast with molding or manipulation, long or short leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63685","name":"Ins/rplc spi npg/rcvr pocket","description":"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11266.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67314","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43280","name":"Laparoscopy fundoplasty","description":"Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52354","name":"Cystouretero w/biopsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73719","name":"Mri lower extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92518","name":"Vemp test i&r ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; ocular (ovemp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27647","name":"Resect talus/calcaneus tum","description":"Radical resection of tumor; talus or calcaneus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14041","name":"Tis trnfr f/c/c/m/n/a/g/h/f","description":"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63620","name":"Srs spinal lesion","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11750","name":"Excision nail&nail matrix","description":"Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"Prev visit est age 18-39","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63066","name":"Decompress spine cord add-on","description":"Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36565","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, tesio type catheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33530","name":"Coronary artery bypass/reop","description":"Reoperation, coronary artery bypass procedure or valve procedure, more than 1 month after original operation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4262","name":"Temporary tear duct plug","description":"Temporary, absorbable lacrimal duct implant, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19564.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25695","name":"Optx lunate dislocation","description":"Open treatment of lunate dislocation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4206","name":"1 cc sterile syringe&needle","description":"Syringe with needle, sterile, 1 cc or less, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42972","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92569","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4915.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20926","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50706","name":"Balloon dilate urtrl strix","description":"Balloon dilation, ureteral stricture, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73222","name":"Mri joint upr extrem w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41000","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0548T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3250","name":"Custom mold shoe remov prost","description":"Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55150","name":"Removal of scrotum","description":"Resection of scrotum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49590","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28190","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; subcutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24620","name":"Cltx monteggia fx dislc elbw","description":"Closed treatment of monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43197","name":"Esophagoscopy flex dx brush","description":"Esophagoscopy, flexible, transnasal; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0161","name":"Sitz bath/equipment w/faucet","description":"Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21235","name":"Ear cartilage graft","description":"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45560","name":"Repair of rectocele","description":"Repair of rectocele (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74301","name":"X-rays at surgery add-on","description":"Cholangiography and/or pancreatography; additional set intraoperative, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95147","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 3 single stinging insect venoms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21180","name":"Rcnstj forehead w/autograft","description":"Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82960","name":"Test for g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); screen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87880","name":"Strep a assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8220.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27409","name":"Repair of knee ligaments","description":"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52310","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62116","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"65750","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in aphakia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54322","name":"Reconstruction of urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, magpi, v-flap)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G2170","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4262.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P7001","name":"Culture bacterial urine","description":"Culture, bacterial, urine; quantitative, sensitivity study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41251","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; posterior one-third of tongue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32480","name":"Partial removal of lung","description":"Removal of lung, other than pneumonectomy; single lobe (lobectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92548","name":"Cdp-sot 6 cond w/i&r","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61215","name":"Ins subq rsvr pmp/nfs sys","description":"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7234.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0693","name":"Uvl sys panel 6 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65757","name":"Prep corneal endo allograft","description":"Backbench preparation of corneal endothelial allograft prior to transplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33620","name":"Apply r&l pulm art bands","description":"Application of right and left pulmonary artery bands (eg, hybrid approach stage 1)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37200","name":"Transcatheter biopsy","description":"Transcatheter biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43205","name":"Esophagus endoscopy/ligation","description":"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87206","name":"Smear fluorescent/acid stai","description":"Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5980.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93312","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64727","name":"Internal neurolysis","description":"Internal neurolysis, requiring use of operating microscope (list separately in addition to code for neuroplasty) (neuroplasty includes external neurolysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87490","name":"Chlmyd trach dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28140","name":"Removal of metatarsal","description":"Metatarsectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43228","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27370","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2996.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27814","name":"Treatment of ankle fracture","description":"Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli, or medial and posterior malleoli), includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68360","name":"Revise eyelid lining","description":"Conjunctival flap; bridge or partial (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15777","name":"Acellular derm matrix implt","description":"Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73218","name":"Mri upper extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27253","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, without internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92616","name":"Fees w/laryngeal sense test","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93526","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57287","name":"Revise/remove sling repair","description":"Removal or revision of sling for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77336","name":"Radiation physics consult","description":"Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86280","name":"Hemagglutination inhibition","description":"Hemagglutination inhibition test (hai)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46211","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58356","name":"Endometrial cryoablation","description":"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4146.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32665","name":"Thoracoscop w/esoph musc exc","description":"Thoracoscopy, surgical; with esophagomyotomy (heller type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83026","name":"Hemoglobin copper sulfate","description":"Hemoglobin; by copper sulfate method, non-automated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43220","name":"Esophagoscopy balloon <30mm","description":"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85441","name":"Heinz bodies direct","description":"Heinz bodies; direct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23600","name":"Cltx prox humrl fx w/o mnpj","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86632","name":"Chlamydia igm antibody","description":"Antibody; chlamydia, igm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41113","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; posterior one-third","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82108","name":"Assay of aluminum","description":"Aluminum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99336","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75996","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20902","name":"Removal of bone for graft","description":"Bone graft, any donor area; major or large","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82651","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31000","name":"Irrigation maxillary sinus","description":"Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61250","name":"Burr hole/treph sttl expl","description":"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0700","name":"Safety equipment","description":"Safety equipment, device or accessory, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61546","name":"Removal of pituitary gland","description":"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49495","name":"Rpr ing hernia baby reduc","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; reducible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90465","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26125","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft); each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41820","name":"Excision gum each quadrant","description":"Gingivectomy, excision gingiva, each quadrant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84120","name":"Assay of urine porphyrins","description":"Porphyrins, urine; quantitation and fractionation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"T4521","name":"Adult size brief/diaper sm","description":"Adult sized disposable incontinence product, brief/diaper, small, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11921","name":"Correct skn color 6.1-20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27664","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"Home/res vst est sf mdm 20","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceede","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61512","name":"Crnec treph exc mngioma sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35571","name":"Art byp pop-tibl-prl-other","description":"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29877","name":"Arthrs knee surg dbrdmt/shvg","description":"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92990","name":"Revision of pulmonary valve","description":"Percutaneous balloon valvuloplasty; pulmonary valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35121","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2039.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27715","name":"Ostpl tibfib lngth/shrt","description":"Osteoplasty, tibia and fibula, lengthening or shortening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87538","name":"Hiv-2 probe&revrse trnscripj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"99288","name":"Direct advanced life support","description":"Physician or other qualified health care professional direction of emergency medical systems (ems) emergency care, advanced life support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36909","name":"Dialysis circuit embolj","description":"Dialysis circuit permanent vascular embolization or occlusion (including main circuit or any accessory veins), endovascular, including all imaging and radiological supervision and interpretation necessary to complete the intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2527.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27766","name":"Optx medial ankle fx","description":"Open treatment of medial malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95925","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4403.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90857","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74262","name":"Ct colonography dx w/dye","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; with contrast material(s) including non-contrast images, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44661","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; with intestine and/or bladder resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32552","name":"Remove lung catheter","description":"Removal of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57000","name":"Colpotomy w/exploration","description":"Colpotomy; with exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46255","name":"Remove int/ext hem 1 group","description":"Hemorrhoidectomy, internal and external, single column/group;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27759","name":"Treatment of tibia fracture","description":"Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31630","name":"Bronchoscopy dilate/fx repr","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01502","name":"Anes px art lower leg emblc","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; embolectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36830","name":"Artery-vein nonautograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (eg, biological collagen, thermoplastic graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85598","name":"Hexagnal phosph pltlt neutrl","description":"Phospholipid neutralization; hexagonal phospholipid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52305","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77435","name":"Sbrt management","description":"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2422.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86771","name":"Shigella antibody","description":"Antibody; shigella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00326","name":"Anes all px larynx&trach<1yr","description":"Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33684","name":"Clsr 1 vsd w/wo patch w/vlvt","description":"Closure of single ventricular septal defect, with or without patch; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1643.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50592","name":"Perc rf ablate renal tumor","description":"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00452","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31730","name":"Intro windpipe wire/tube","description":"Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27440","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33289","name":"Tcat impl wrls p-art prs snr","description":"Transcatheter implantation of wireless pulmonary artery pressure sensor for long-term hemodynamic monitoring, including deployment and calibration of the sensor, right heart catheterization, selective pulmonary catheterization, radiological supervision and interpretation, and pulmonary artery angiog","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92603","name":"Cochlear implt f/up exam 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; with programming","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00865","name":"Anes xtrprt lwr abd prst8ect","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19300","name":"Mastectomy for gynecomastia","description":"Mastectomy for gynecomastia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33404","name":"Prepare heart-aorta conduit","description":"Construction of apical-aortic conduit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1517.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25280","name":"Revise wrist/forearm tendon","description":"Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61571","name":"Incise skull for brain wound","description":"Craniectomy or craniotomy; with treatment of penetrating wound of brain","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21160","name":"Rcnst mdfc lfrtiii advm w/i","description":"Reconstruction midface, lefort iii (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with lefort i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64755","name":"Incision of stomach nerves","description":"Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or highly selective vagotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25565","name":"Cltx rdl&uln shft fx w/mnpj","description":"Closed treatment of radial and ulnar shaft fractures; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31632","name":"Bronchoscopy/lung bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9686","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46735","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75790","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89051","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12045","name":"Intmd rpr n-hf/genit12.6-20","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11420","name":"Exc h-f-nk-sp b9+marg 0.5/<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37227","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26990","name":"Drainage of pelvis lesion","description":"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87341","name":"Hep b surface ag neutrlzj ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag) neutralization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44390","name":"Colonoscopy for foreign body","description":"Colonoscopy through stoma; with removal of foreign body(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15740","name":"Island pedicle flap graft","description":"Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80166","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87209","name":"Smear complex stain","description":"Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4709","name":"Acid conc sol per gallon","description":"Acid concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63088","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93229","name":"Remote 30 day ecg tech supp","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67318","name":"Revise eye muscle(s)","description":"Strabismus surgery, any procedure, superior oblique muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22802","name":"Arthrd pst dfrm 7-12 vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64835","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; median motor thenar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8105.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50325","name":"Prep donor renal graft","description":"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45385","name":"Colonoscopy w/lesion removal","description":"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1487.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4220","name":"Parenteral supply kit premix","description":"Parenteral nutrition supply kit; premix, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97164","name":"Pt re-eval est plan care","description":"Re-evaluation of physical therapy established plan of care, requiring these components: an examination including a review of history and use of standardized tests and measures is required; and revised plan of care using a standardized patient assessment instrument and/or measurable assessment of fun","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94240","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27647","name":"Resect talus/calcaneus tum","description":"Radical resection of tumor; talus or calcaneus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78453","name":"Ht muscle image planar sing","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25609","name":"Optx dst rd xart fx/ep sep3+","description":"Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61598","name":"Transpetrosal approach/skull","description":"Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50432","name":"Plmt nephrostomy catheter","description":"Placement of nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4536","name":"Reusable pull-on any size","description":"Incontinence product, protective underwear/pull-on, reusable, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"10022","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43771","name":"Lap revise gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49082","name":"Abd paracentesis","description":"Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99305","name":"1st nf care moderate mdm 35","description":"Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minutes must be met or ex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67882","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58920","name":"Partial removal of ovary(s)","description":"Wedge resection or bisection of ovary, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89322","name":"Semen anal strict criteria","description":"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, kruger)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99310","name":"Sbsq nf care high mdm 45","description":"Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 45 minutes must be met or exc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28045","name":"Exc foot/toe tum deep <1.5cm","description":"Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69631","name":"Repair eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3217","name":"Ladies shoes hightop depth i","description":"Orthopedic footwear, ladies shoe, hightop, depth inlay, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59857","name":"Induced ab 1+vag supp hyst","description":"Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with hysterotomy (failed medical evacuation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0483","name":"Drug test def 22+ classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21142","name":"Rcnstj midface lefort i 2pcs","description":"Reconstruction midface, lefort i; 2 pieces, segment movement in any direction, without bone graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0483T","name":"Tmvi percutaneous approach","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57287","name":"Revise/remove sling repair","description":"Removal or revision of sling for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99606","name":"Mtms by pharm est 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, established patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99328","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50785","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with vesico-psoas hitch or bladder flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44394","name":"Colonoscopy w/snare","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11755.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56821","name":"Colposcopy vulva w/biopsy","description":"Colposcopy of the vulva; with biopsy(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5160.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65272","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13121","name":"Cmplx rpr s/a/l 2.6-7.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1762.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21810","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80182","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42808","name":"Excise pharynx lesion","description":"Excision or destruction of lesion of pharynx, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69401","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"P9037","name":"Plate pheres leukoredu irrad","description":"Platelets, pheresis, leukocytes reduced, irradiated, each unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55530","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33781","name":"Rpr tga rcnstj rpr sbpl obst","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with repair of subpulmonic obstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23575","name":"Cltx scap fx w/mnpj +-tractj","description":"Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67010","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88318","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21632","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27325","name":"Neurectomy hamstring","description":"Neurectomy, hamstring muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4046.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84512","name":"Assay of troponin qual","description":"Troponin, qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88262","name":"Chromosome analysis 15-20","description":"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82308","name":"Assay of calcitonin","description":"Calcitonin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27610","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3030.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0499","name":"Hepb screen high risk indiv","description":"Hepatitis b screening in non-pregnant, high risk individual includes hepatitis b surface antigen (hbsag), antibodies to hbsag (anti-hbs) and antibodies to hepatitis b core antigen (anti-hbc), and is followed by a neutralizing confirmatory test, when performed, only for an initially reactive hbsag re","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86829","name":"Hla class i/ii antibody qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); qualitative assessment of the presence or absence of antibody(ies) to hla class i or class ii hla antigens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2584.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93458","name":"L hrt artery/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15976.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48102","name":"Needle biopsy pancreas","description":"Biopsy of pancreas, percutaneous needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90869","name":"Tcran magn stim redetemine","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent motor threshold re-determination with delivery and management","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11183.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61440","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5311","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93235","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35013","name":"Repair artery rupture arm","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83701","name":"Lipoprotein bld hr fraction","description":"Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins including lipoprotein subclasses when performed (eg, electrophoresis, ultracentrifugation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38573","name":"Laps pelvic lymphadec","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81190","name":"Cstb gene known famil vrnt","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; known familial variant(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95716","name":"Veeg ea 12-26hr cont mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99244","name":"Off/op cnsltj new/est mod 40","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01390","name":"Anes cls px upr tib fib&/pat","description":"Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1734.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98961","name":"Edu&trn pt slf-mgmt nqhp 2-4","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45520","name":"Treatment of rectal prolapse","description":"Perirectal injection of sclerosing solution for prolapse","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78414","name":"Non-imaging heart function","description":"Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction with probe technique) with or without pharmacologic intervention or exercise, single or multiple determinations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89141","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44360","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0519T","name":"Rmv&rplcmt pg wcs lv both","description":"Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; both components (battery and transmitter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21235","name":"Ear cartilage graft","description":"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9981","name":"Remote e/m new pt 45mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37191","name":"Ins endovas vena cava filtr","description":"Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27193","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10021","name":"Fna bx w/o img gdn 1st les","description":"Fine needle aspiration biopsy, without imaging guidance; first lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36819","name":"Av fuse uppr arm basilic","description":"Arteriovenous anastomosis, open; by upper arm basilic vein transposition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21195","name":"Reconst lwr jaw w/o fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15430","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L7510","name":"Prosthetic device repair rep","description":"Repair of prosthetic device, repair or replace minor parts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87901","name":"Nfct agt gntyp alys hiv1 rev","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, reverse transcriptase and protease regions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94360","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35889.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12002","name":"Rpr s/n/ax/gen/trnk2.6-7.5cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35536","name":"Art byp grft splenorenal","description":"Bypass graft, with vein; splenorenal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47010","name":"Hepatot opn drg absc/cst 1/2","description":"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99340","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57421","name":"Exam/biopsy of vag w/scope","description":"Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84830","name":"Ovulation tests","description":"Ovulation tests, by visual color comparison methods for human luteinizing hormone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93227","name":"Xtrnl ecg rec<48 hr r&i","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3493.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G2014","name":"Post-d/c care plan overs 30m","description":"Limited (30 minutes) care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than 9 times.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15824","name":"Rhytidectomy forehead","description":"Rhytidectomy; forehead","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2129.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46744","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2967.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51715","name":"Endoscopic injection/implant","description":"Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45910","name":"Dilation of rectal narrowing","description":"Dilation of rectal stricture (separate procedure) under anesthesia other than local","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97168","name":"Ot re-eval est plan care","description":"Re-evaluation of occupational therapy established plan of care, requiring these components: an assessment of changes in patient functional or medical status with revised plan of care; an update to the initial occupational profile to reflect changes in condition or environment that affect future inte","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95873","name":"Guide nerv destr elec stim","description":"Electrical stimulation for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28086","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; flexor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63304","name":"Remove vert idrl body crvcl","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29065","name":"Appl cst sho to hand lng arm","description":"Application, cast; shoulder to hand (long arm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21485","name":"Cltx tmprmand dislc comp","description":"Closed treatment of temporomandibular dislocation; complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0239","name":"Oth resp proc, group","description":"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27530","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4209","name":"5+ cc sterile syringe&needle","description":"Syringe with needle, sterile 5 cc or greater, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95724","name":"Eeg phy/qhp>60<84 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 60 hours, up to 84 hours of eeg recording, with video (veeg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4126.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36456","name":"Prtl exchange transfuse nb","description":"Partial exchange transfusion, blood, plasma or crystalloid necessitating the skill of a physician or other qualified health care professional, newborn","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78267","name":"Urea breath tst c-14 acquisj","description":"Urea breath test, c-14 (isotopic); acquisition for analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58552","name":"Laparo-vag hyst incl t/o","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51701","name":"Insert bladder catheter","description":"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33430","name":"Replacement of mitral valve","description":"Replacement, mitral valve, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54312","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26121","name":"Release palm contracture","description":"Fasciectomy, palm only, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58951","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73706","name":"Ct angio lwr extr w/o&w/dye","description":"Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64455","name":"Njx aa&/strd pltr com dg nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; plantar common digital nerve(s) (eg, mortons neuroma)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34843","name":"Endovasc visc aorta 3 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95065","name":"Dir nsl mucous membrane test","description":"Direct nasal mucous membrane test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27882","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; open, circular (guillotine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0304","name":"Hosp bed xtra hvy dty x wide","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8035.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17437.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97535","name":"Self care mngment training","description":"Self-care/home management training (eg, activities of daily living (adl) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26479","name":"Shortening of hand tendon","description":"Shortening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36810","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (scribner type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26489","name":"Transplant/graft palm tendon","description":"Transfer or transplant of tendon, palmar; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86694","name":"Herpes simplex nes antbdy","description":"Antibody; herpes simplex, non-specific type test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26116","name":"Exc hand tum deep < 1.5 cm","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81343","name":"Ppp2r2b gen detc abnor allel","description":"Ppp2r2b (protein phosphatase 2 regulatory subunit bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3208","name":"Surgical boot each infant","description":"Surgical boot, each, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25830","name":"Arthrd dst rad/ul jt sgm rsc","description":"Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, sauve-kapandji procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"Office o/p est mod 30 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15171","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21931","name":"Exc back les sc 3 cm/>","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0232T","name":"Njx platelet plasma","description":"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85415","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen activator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0172T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22903","name":"Exc abd les sc 3 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69718","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35879","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4185","name":"Pn soln nos 10 grams lipids","description":"Parenteral nutrition solution, not otherwise specified, 10 grams lipids","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0877","name":"Pwc gp4 std sing pow opt s/b","description":"Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"R0075","name":"Transport port x-ray multipl","description":"Transportation of portable x-ray equipment and personnel to home or nursing home, per trip to facility or location, more than one patient seen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50800","name":"Implant ureter in bowel","description":"Ureteroenterostomy, direct anastomosis of ureter to intestine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"Spirometry up to 2 yrs old","description":"Measurement of spirometric forced expiratory flows in an infant or child through 2 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44015","name":"Insert needle cath bowel","description":"Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42415","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50236","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through separate incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43210","name":"Egd esophagogastrc fndoplsty","description":"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95726","name":"Eeg phy/qhp>84 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of eeg recording, with video (veeg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4081","name":"Enteral ng tubing w/ stylet","description":"Nasogastric tubing with stylet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"42842","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67030","name":"Incise inner eye strands","description":"Discission of vitreous strands (without removal), pars plana approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33983","name":"Replace vad intra w/bp","description":"Replacement of ventricular assist device pump(s); implantable intracorporeal, single ventricle, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0455","name":"Fecal microbiota prep instil","description":"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0248T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44208","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54308","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0638","name":"Standing frame sys","description":"Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93454","name":"Coronary artery angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37228","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0076T","name":"S&i stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33949","name":"Ecmo/ecls daily mgmt artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-arterial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99358","name":"Prolong service w/o contact","description":"Prolonged evaluation and management service before and/or after direct patient care; first hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28420","name":"Optx calcaneal fx w/bone grf","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed; with primary iliac or other autogenous bone graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84376","name":"Sugars single qual","description":"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L6025","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50570","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87332","name":"Cytomegalovirus ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; cytomegalovirus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75680","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50951","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76811","name":"Ob us detailed sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65114","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with muscle or myocutaneous flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8170.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31239","name":"Nsl/sinus endoscopy surg dcr","description":"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6524.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47538","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; existing ac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76983","name":"Use ea addl target lesion","description":"Ultrasound, elastography; each additional target lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37243","name":"Vasc embolize/occlude organ","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31600","name":"Planned tracheostomy","description":"Tracheostomy, planned (separate procedure);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67343","name":"Release eye tissue","description":"Release of extensive scar tissue without detaching extraocular muscle (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68540","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; frontal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8227.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3817.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11772","name":"Exc pilonidal cyst comp","description":"Excision of pilonidal cyst or sinus; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33974","name":"Remove intra-aortic balloon","description":"Removal of intra-aortic balloon assist device from the ascending aorta, including repair of the ascending aorta, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21110","name":"Interdental fixation","description":"Application of interdental fixation device for conditions other than fracture or dislocation, includes removal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93355","name":"Echo transesophageal (tee)","description":"Echocardiography, transesophageal (tee) for guidance of a transcatheter intracardiac or great vessel(s) structural intervention(s) (eg, tavr, transcatheter pulmonary valve replacement, mitral valve repair, paravalvular regurgitation repair, left atrial appendage occlusion/closure, ventricular septal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43285","name":"Rmvl esophgl sphnctr dev","description":"Removal of esophageal sphincter augmentation device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87557","name":"M.tuberculo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95719","name":"Eeg phys/qhp ea incr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of eeg recording, interpretation and report after each 24-hour period; w","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62329","name":"Ther spi pnxr csf fluor/ct","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter); with fluoroscopic or ct guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92371","name":"Rpr&refit spct prsth aphakia","description":"Repair and refitting spectacles; spectacle prosthesis for aphakia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27033","name":"Arthrt hip expl/rmv loose/fb","description":"Arthrotomy, hip, including exploration or removal of loose or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63199","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27442","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92060","name":"Sensorimotor examination","description":"Sensorimotor examination with multiple measurements of ocular deviation (eg, restrictive or paretic muscle with diplopia) with interpretation and report (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43882","name":"Rev/rmvl gstr nstim eltrd","description":"Revision or removal of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46080","name":"Sphnctrotmy anal div sphnctr","description":"Sphincterotomy, anal, division of sphincter (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2384.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61540","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80422","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for insulinoma this panel must include the following: glucose (82947 x 3) insulin (83525 x 3)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36215","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31259","name":"Nsl/sins ndsc sphn tiss rmvl","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28240","name":"Release of big toe","description":"Tenotomy, lengthening, or release, abductor hallucis muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6393.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26215","name":"Remove/graft finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48551","name":"Prep donor pancreas","description":"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and y-graft arterial anastomoses from iliac artery to superio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43456","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77083","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15275","name":"Skin sub graft face/nk/hf/g","description":"Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5947.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88387","name":"Macroscopic xm dsj&prep tiss","description":"Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies), each tissue preparation (eg, a single lymph node)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2196.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"11043","name":"Dbrdmt musc&/fsca 1st 20/<","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86835","name":"Hla class ii semiquant panel","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); semi-quantitative panel (eg, titer), hla class ii","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76350","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11667.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25608","name":"Optx dst rd xart fx/epi sep2","description":"Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58740","name":"Adhesiolysis tube ovary","description":"Lysis of adhesions (salpingolysis, ovariolysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43840","name":"Gstrrphy sutr duol/gstr ulcr","description":"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28981.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64612","name":"Destroy nerve face muscle","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12015","name":"Rpr f/e/e/n/l/m 7.6-12.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63012","name":"Remove lamina/facets lumbar","description":"Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (gill type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88720","name":"Bilirubin total transcut","description":"Bilirubin, total, transcutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49000","name":"Exploration of abdomen","description":"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44602","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88309","name":"Tissue exam by pathologist","description":"Level vi - surgical pathology, gross and microscopic examination bone resection breast, mastectomy - with regional lymph nodes colon, segmental resection for tumor colon, total resection esophagus, partial/total resection extremity, disarticulation fetus, with dissection larynx, partial/total resect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59051","name":"Fetal monitor/interpret only","description":"Fetal monitoring during labor by consulting physician (ie, non-attending physician) with written report; interpretation only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00402","name":"Anes integ sys rcnstv breast","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36005","name":"Injection ext venography","description":"Injection procedure for extremity venography (including introduction of needle or intracatheter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58670","name":"Laparoscopy tubal cautery","description":"Laparoscopy, surgical; with fulguration of oviducts (with or without transection)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83913","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93279","name":"Prgrmg dev eval pm/ldls pm","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system or","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61850","name":"Implant neuroelectrodes","description":"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28225","name":"Release of foot tendon","description":"Tenolysis, extensor, foot; single tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2201.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50555","name":"Kidney endoscopy & biopsy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99328","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21495","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","HA"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28299","name":"Cor hlx vlgs double osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99489","name":"Cplx chrnc care ea addl 30","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67801","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, same lid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41108","name":"Biopsy of floor of mouth","description":"Biopsy of floor of mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20697","name":"App mltpln uni xtrnl fix xch","description":"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; exchange (ie, removal and replacement) of strut, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63046","name":"Lam facetec & foramot thrc","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6404","name":"Sterile gauze > 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96167","name":"Hlth bhv ivntj fam 1st 30","description":"Health behavior intervention, family (with the patient present), face-to-face; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59130","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; abdominal pregnancy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92018","name":"Compl oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11922","name":"Correct skin color ea 20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95922","name":"Autonomic nrv adrenrg inervj","description":"Testing of autonomic nervous system function; vasomotor adrenergic innervation (sympathetic adrenergic function), including beat-to-beat blood pressure and r-r interval changes during valsalva maneuver and at least 5 minutes of passive tilt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3825.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25909","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; re-amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76828","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; follow-up or repeat study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28505","name":"Treat big toe fracture","description":"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37192","name":"Redo endovas vena cava filtr","description":"Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5060.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"Prev visit est age 12-17","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65775","name":"Correction of astigmatism","description":"Corneal wedge resection for correction of surgically induced astigmatism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97165","name":"Ot eval low complex 30 min","description":"Occupational therapy evaluation, low complexity, requiring these components: an occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; an assessment(s) that identifies 1-3 performance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57160","name":"Insert pessary/other device","description":"Fitting and insertion of pessary or other intravaginal support device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32820","name":"Reconstruct injured chest","description":"Major reconstruction, chest wall (posttraumatic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20552","name":"Njx 1/mlt trigger point 1/2","description":"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95803","name":"Actigraphy testing","description":"Actigraphy testing, recording, analysis, interpretation, and report (minimum of 72 hours to 14 consecutive days of recording)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92240","name":"Icg angiography i&r uni/bi","description":"Indocyanine-green angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26210","name":"Removal of finger lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19297","name":"Place breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36216","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; initial second order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0457","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35525","name":"Art byp grft brachial-brchl","description":"Bypass graft, with vein; brachial-brachial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12014","name":"Rpr f/e/e/n/l/m 5.1-7.5 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20101","name":"Expl pentrg wound chest","description":"Exploration of penetrating wound (separate procedure); chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26440","name":"Release palm/finger tendon","description":"Tenolysis, flexor tendon; palm or finger, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17437.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4918","name":"Venous pressure clamp","description":"Venous pressure clamp, for hemodialysis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0463","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4725","name":"Dialys sol fld vol > 4999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3157.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14350","name":"Filleted finger/toe flap","description":"Filleted finger or toe flap, including preparation of recipient site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27508","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83634","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"56821","name":"Colposcopy vulva w/biopsy","description":"Colposcopy of the vulva; with biopsy(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47490","name":"Incision of gallbladder","description":"Cholecystostomy, percutaneous, complete procedure, including imaging guidance, catheter placement, cholecystogram when performed, and radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94617","name":"Exercise tst brncspsm w/ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; with electrocardiographic recording(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55520","name":"Removal of sperm cord lesion","description":"Excision of lesion of spermatic cord (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33946","name":"Ecmo/ecls initiation venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-venous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90581","name":"Anthrax vaccine sc or im","description":"Anthrax vaccine, for subcutaneous or intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35522","name":"Art byp grft axill-brachial","description":"Bypass graft, with vein; axillary-brachial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35903","name":"Excision graft extremity","description":"Excision of infected graft; extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86870","name":"Rbc antibody identification","description":"Antibody identification, rbc antibodies, each panel for each serum technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0479T","name":"Fxjl abl lsr 1st 100 sq cm","description":"Fractional ablative laser fenestration of burn and traumatic scars for functional improvement; first 100 cm2 or part thereof, or 1% of body surface area of infants and children","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17108","name":"Dstr cut vsc prlf les>50sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2062","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54560","name":"Exploration for testis","description":"Exploration for undescended testis with abdominal exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29825","name":"Sho arthrs srg lss&rescj ads","description":"Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27134","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; both components, with or without autograft or allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76801","name":"Ob us < 14 wks single fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63086","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95979","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87635","name":"Sars-cov-2 covid-19 amp prb","description":"Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2826.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43842","name":"Gstr rstcv px v-banded gstp","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64410","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4868.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0320","name":"Two-way audio and video hhs","description":"Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15300","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99490","name":"Chrnc care mgmt staff 1st 20","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21408","name":"Opn tx orbit fx w/bone grft","description":"Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99495","name":"Transj care mgmt mod f2f 14d","description":"Transitional care management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge at least moderate level of medical decision making during the service period face-to-face visit, wit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35681","name":"Composite byp grft pros&vein","description":"Bypass graft; composite, prosthetic and vein (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86922","name":"Compatibility test antiglob","description":"Compatibility test each unit; antiglobulin technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54105","name":"Biopsy of penis","description":"Biopsy of penis; deep structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55720","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0190","name":"Positioning cushion","description":"Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23460.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87481","name":"Candida dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85301","name":"Antithrombin iii antigen","description":"Clotting inhibitors or anticoagulants; antithrombin iii, antigen assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33917","name":"Repair pulmonary artery","description":"Repair of pulmonary artery stenosis by reconstruction with patch or graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36861","name":"Cannula declotting","description":"External cannula declotting (separate procedure); with balloon catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65290","name":"Repair of eye socket wound","description":"Repair of wound, extraocular muscle, tendon and/or tenons capsule","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33019","name":"Perq prcrd drg insj cath ct","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including ct guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24357","name":"Repair elbow perc","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81237","name":"Ezh2 gene common variants","description":"Ezh2 (enhancer of zeste 2 polycomb repressive complex 2 subunit) (eg, diffuse large b-cell lymphoma) gene analysis, common variant(s) (eg, codon 646)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83735","name":"Assay of magnesium","description":"Magnesium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21012","name":"Exc face les sbq 2 cm/>","description":"Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58356","name":"Endometrial cryoablation","description":"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95148","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 4 single stinging insect venoms","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66987","name":"Xcapsl ctrc rmvl cplx w/ecp","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27468","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01274","name":"Anes px art fem art emblc","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery embolectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10970.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64624","name":"Dstrj nulyt agt gnclr nrv","description":"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84490","name":"Assay of feces for trypsin","description":"Trypsin; feces, quantitative, 24-hour collection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51585","name":"Removal of bladder & nodes","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86902","name":"Blood type antigen donor ea","description":"Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00406","name":"Anes integ sys rad brst dsj","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast with internal mammary node dissection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25606","name":"Perq skel fixj dstl rdl fx","description":"Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2333.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77048","name":"Mri breast c-+ w/cad uni","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85292","name":"Clot factor fletcher fact","description":"Clotting; prekallikrein assay (fletcher factor assay)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86376","name":"Microsomal antibody each","description":"Microsomal antibodies (eg, thyroid or liver-kidney), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1470.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26665","name":"Treat thumb fracture","description":"Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P2038","name":"Blood mucoprotein","description":"Mucoprotein, blood (seromucoid) (medical necessity procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0298T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19305","name":"Mast radical","description":"Mastectomy, radical, including pectoral muscles, axillary lymph nodes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27517","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42280","name":"Preparation palate mold","description":"Maxillary impression for palatal prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82666","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78594","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66160","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54640","name":"Orchiopexy ingun/scrot appr","description":"Orchiopexy, inguinal or scrotal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2120.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24300","name":"Mnpj elbow under anes","description":"Manipulation, elbow, under anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20932","name":"Osteoart algrft w/surf & b1","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; osteoarticular, including articular surface and contiguous bone (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36572","name":"Insj picc rs&i <5 yr","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; younger than 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47370","name":"Laparo ablate liver tumor rf","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24802","name":"Arthrd elbow jt autog graft","description":"Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29806","name":"Sho arthrs srg capsulorraphy","description":"Arthroscopy, shoulder, surgical; capsulorrhaphy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35647","name":"Bpg aortofemoral","description":"Bypass graft, with other than vein; aortofemoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30320","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; by lateral rhinotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4463.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11057","name":"Parng/cutg b9 hyprkr les >4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92070","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40805","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71552","name":"Mri chest w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11443","name":"Exc face-mm b9+marg 2.1-3 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49423","name":"Exchange drainage catheter","description":"Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46740","name":"Construction of absent anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27637","name":"Remove/graft leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80428","name":"Growth hormone panel","description":"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) this panel must include the following: human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78472","name":"Gated heart planar single","description":"Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without additional quantitative processing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21150","name":"Rcnstj mdfc lefrtii ant ntru","description":"Reconstruction midface, lefort ii; anterior intrusion (eg, treacher-collins syndrome)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33724","name":"Repair venous anomaly","description":"Repair of isolated partial anomalous pulmonary venous return (eg, scimitar syndrome)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99185","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0147T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30118","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21015","name":"Resect face/scalp tum < 2 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; less than 2 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15170","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29025","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31546","name":"Remove vc lesion scope/graft","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25635","name":"Cltx carpl fx w/mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); with manipulation, each bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21206","name":"Reconstruct upper jaw bone","description":"Osteotomy, maxilla, segmental (eg, wassmund or schuchard)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4575","name":"Hyperbaric o2 chamber disps","description":"Topical hyperbaric oxygen chamber, disposable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15100","name":"Splt agrft t/a/l 1st 100sqcm","description":"Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96136","name":"Psycl/nrpsyc tst phy/qhp 1st","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9484","name":"Remote e/m new pt 45mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27105","name":"Transfer of spinal muscle","description":"Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33513","name":"Cabg vein four","description":"Coronary artery bypass, vein only; 4 coronary venous grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25440","name":"Repair nonu scphd carpl b1","description":"Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65810","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75558","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22336.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93459","name":"L hrt art/grft angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter place","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6296.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31575","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, flexible; diagnostic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28400","name":"Cltx calcaneal fx w/o mnpj","description":"Closed treatment of calcaneal fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63088","name":"Remove vertebral body add-on","description":"Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0075T","name":"Perq stent/chest vert art","description":"Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21395","name":"Opn tx orbit periorbt w/grft","description":"Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63621","name":"Srs spinal lesion addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67973","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58400","name":"Suspension of uterus","description":"Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38205","name":"Harvest allogeneic stem cell","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87390","name":"Hiv-1 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83519","name":"Ria nonantibody","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, ria)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36905","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95706","name":"Eeg wo vid 2-12hr intmt mntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; with intermittent monitoring and maintenance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29882","name":"Arthrs kne srg mnisc rpr m/l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26508","name":"Release thumb contracture","description":"Release of thenar muscle(s) (eg, thumb contracture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63055","name":"Decompress spinal cord thrc","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0394","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34718","name":"Evasc rpr n/a a-iliac ndgft","description":"Endovascular repair of iliac artery, not associated with placement of an aorto-iliac artery endograft at the same session, by deployment of an iliac branched endograft, including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88140","name":"Sex chromatin identification","description":"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28297","name":"Cor hlx vlgs jt arthrd","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27455","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); before epiphyseal closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77012","name":"Ct scan for needle biopsy","description":"Computed tomography guidance for needle placement (eg, biopsy, aspiration, injection, localization device), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80051","name":"Electrolyte panel","description":"Electrolyte panel this panel must include the following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49521","name":"Rerepair ing hernia blocked","description":"Repair recurrent inguinal hernia, any age; incarcerated or strangulated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27870","name":"Fusion of ankle joint open","description":"Arthrodesis, ankle, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9157","name":"Transesoph doppl cardiac mon","description":"Transesophageal doppler measurement of cardiac output (including probe placement, image acquisition, and interpretation per course of treatment) for monitoring purposes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58600","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88143","name":"Cytopath c/v thin layer redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with manual screening and rescreening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86664","name":"Epstein-barr nuclear antigen","description":"Antibody; epstein-barr (eb) virus, nuclear antigen (ebna)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15330","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36469","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25907","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; secondary closure or scar revision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97760","name":"Orthotic mgmt&traing 1st enc","description":"Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88386","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63011","name":"Remove spine lamina 1/2 scrl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33920","name":"Repair pulmonary atresia","description":"Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to pulmonary artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90807","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4590","name":"Special casting material","description":"Special casting material (e.g., fiberglass)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33335","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52005","name":"Cysto w/urtrl cathj","description":"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87800","name":"Detect agnt mult dna direc","description":"Infectious agent detection by nucleic acid (dna or rna), multiple organisms; direct probe(s) technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50020","name":"Drg perirnl/renal absc open","description":"Drainage of perirenal or renal abscess, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87799","name":"Detect agent nos dna quant","description":"Infectious agent detection by nucleic acid (dna or rna), not otherwise specified; quantification, each organism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4340.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4510","name":"Full length surg stocking","description":"Surgical stockings full length, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0085","name":"Care man h v ext pt 75 m","description":"Extensive (75 minutes) care management home visit for an existing patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4521","name":"Adult size brief/diaper sm","description":"Adult sized disposable incontinence product, brief/diaper, small, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40818","name":"Excise oral mucosa for graft","description":"Excision of mucosa of vestibule of mouth as donor graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4230","name":"Infus insulin pump non needl","description":"Infusion set for external insulin pump, non needle cannula type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60521","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44720","name":"Prep donor intestine/venous","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; venous anastomosis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2305.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33465","name":"Replace tricuspid valve","description":"Replacement, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63307","name":"Remov vert idrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2211.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95079","name":"Ingest challenge addl 60 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); each additional 60 minutes of testing (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28730","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0238T","name":"Trluml perip athrc iliac art","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75671","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31629","name":"Bronchoscopy/needle bx each","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26720","name":"Treat finger fracture each","description":"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47140","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments ii and iii)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28124","name":"Partial removal of toe","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47100","name":"Wedge biopsy of liver","description":"Biopsy of liver, wedge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3532.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32852","name":"Lung transplant with bypass","description":"Lung transplant, single; with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2859.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93228","name":"Remote 30 day ecg rev/report","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8644.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63303","name":"Remov vert xdrl bdy lmbr/sac","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47562","name":"Laparoscopic cholecystectomy","description":"Laparoscopy, surgical; cholecystectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88274","name":"Cytogenetics 25-99","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51727","name":"Cystometrogram w/up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66505","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64905","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; first stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33226","name":"Reposition l ventric lead","description":"Repositioning of previously implanted cardiac venous system (left ventricular) electrode (including removal, insertion and/or replacement of existing generator)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54160","name":"Circumcision neonate","description":"Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42821","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; age 12 or over","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95705","name":"Eeg w/o vid 2-12 hr unmntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; unmonitored","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87483","name":"Cns dna amp probe type 12-25","description":"Infectious agent detection by nucleic acid (dna or rna); central nervous system pathogen (eg, neisseria meningitidis, streptococcus pneumoniae, listeria, haemophilus influenzae, e. coli, streptococcus agalactiae, enterovirus, human parechovirus, herpes simplex virus type 1 and 2, human herpesvirus 6","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"Office o/p est low 20 min","description":"Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or e","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7178.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30620","name":"Intranasal reconstruction","description":"Septal or other intranasal dermatoplasty (does not include obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62010","name":"Treatment of head injury","description":"Elevation of depressed skull fracture; with repair of dura and/or debridement of brain","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24077","name":"Rad rescj tum tiss a/e <5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61697","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28545","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92508","name":"Tx sp lang voice comm group","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; group, 2 or more individuals","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24149","name":"Radical resection of elbow","description":"Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with contracture release (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"89235","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20705","name":"Rmvl i-artic rx delivery dev","description":"Removal of drug-delivery device(s), intra-articular (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50382","name":"Change ureter stent percut","description":"Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63290","name":"Bx/exc xdrl/idrl lsn any lvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34111","name":"Removal of arm artery clot","description":"Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88350","name":"Imfluor ea addl 1antb stn px","description":"Immunofluorescence, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12767.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61799","name":"Srs cran les complex addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, complex (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99475","name":"Ped crit care age 2-5 init","description":"Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33210","name":"Insert electrd/pm cath sngl","description":"Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22904","name":"Radical resect abd tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31578","name":"Largsc w/removal lesion","description":"Laryngoscopy, flexible; with removal of lesion(s), non-laser","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96159","name":"Hlth bhv ivntj indiv ea addl","description":"Health behavior intervention, individual, face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0101T","name":"Esw muscskel sys nos","description":"Extracorporeal shock wave involving musculoskeletal system, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37209","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33510","name":"Cabg vein single","description":"Coronary artery bypass, vein only; single coronary venous graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22548","name":"Arthrd ant toral/xoral c1-c2","description":"Arthrodesis, anterior transoral or extraoral technique, clivus-c1-c2 (atlas-axis), with or without excision of odontoid process","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3822.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21193","name":"Reconst lwr jaw w/o graft","description":"Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; without bone graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27479","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62163","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"10061","name":"I&d abscess comp/multiple","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62258","name":"Replace brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; with replacement by similar or other shunt at same operation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12056","name":"Intmd rpr face/mm 20.1-30.0","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33230","name":"Insrt pulse gen w/dual leads","description":"Insertion of implantable defibrillator pulse generator only; with existing dual leads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29914","name":"Hip arthro w/femoroplasty","description":"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20934","name":"Intercalary algrft compl","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; intercalary, complete (ie, cylindrical) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93235","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35331","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; abdominal aorta","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86003","name":"Allg spec ige crude xtrc ea","description":"Allergen specific ige; quantitative or semiquantitative, crude allergen extract, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3371.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447T","name":"Rmvl impltbl glucose sensor","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46211","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2214","name":"Init/sub psych care m 1st 30","description":"Initial or subsequent psychiatric collaborative care management, first 30 minutes in a month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86078","name":"Phys blood bank serv reactj","description":"Blood bank physician services; investigation of transfusion reaction including suspicion of transmissible disease, interpretation and written report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61615","name":"Resect/excise lesion skull","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or c1-c3 vertebral bodies; extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2550.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00320","name":"Anes all px neck nos 1yr/>","description":"Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35501","name":"Art byp grft ipsilat carotid","description":"Bypass graft, with vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63741","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11920","name":"Correct skin color 6.0 cm/<","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50575","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertio","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27176","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34842","name":"Endovasc visc aorta 2 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46742","name":"Repair of imperforated anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4913.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33019","name":"Perq prcrd drg insj cath ct","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including ct guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0290T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43206","name":"Esoph optical endomicroscopy","description":"Esophagoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93650","name":"Icar cath abltj av node func","description":"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45397","name":"Lap remove rectum w/pouch","description":"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11022.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43191","name":"Esophagoscopy rigid trnso dx","description":"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65779","name":"Cover eye w/membrane suture","description":"Placement of amniotic membrane on the ocular surface; single layer, sutured","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9560","name":"Tc99m labeled rbc","description":"Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95710","name":"Eeg w/o vid ea 12-26hr cont","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; with continuous, real-time monitoring and maintenance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50225","name":"Removal kidney open complex","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92558","name":"Evoked auditory test qual","description":"Evoked otoacoustic emissions, screening (qualitative measurement of distortion product or transient evoked otoacoustic emissions), automated analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33018","name":"Prcrd drg 0-5yr or w/anomly","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including fluoroscopy and/or ultrasound guidance, when performed; birth through 5 years of age or any age with congenital cardiac anomaly","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2643.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4668.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41251","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; posterior one-third of tongue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87802","name":"Strep b assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; streptococcus, group b","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01924","name":"Anes ther ivntl rad artl nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95851","name":"Range of motion measurements","description":"Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2276.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33953","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67917","name":"Repair eyelid defect","description":"Repair of ectropion; extensive (eg, tarsal strip operations)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3822.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2204.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43848","name":"Revj open gstr rstcv px","description":"Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric restrictive device (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22515","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53665","name":"Dilation of urethra","description":"Dilation of female urethra, general or conduction (spinal) anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33413","name":"Replacement of aortic valve","description":"Replacement, aortic valve; by translocation of autologous pulmonary valve with allograft replacement of pulmonary valve (ross procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30120","name":"Revision of nose","description":"Excision or surgical planing of skin of nose for rhinophyma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33255","name":"Ablate atria w/o bypass ext","description":"Operative tissue ablation and reconstruction of atria, extensive (eg, maze procedure); without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["SL","HA"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43640","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32507","name":"Wedge resect of lung diag","description":"Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92997","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74170","name":"Ct abd wo cntrst flwd cntrst","description":"Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43250","name":"Egd cautery tumor polyp","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00797","name":"Anes iper upr abd gstr px mo","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28046","name":"Resect foot/toe tumor < 3 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63042","name":"Laminotomy single lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33688","name":"Clsr 1vsd w/wo ptch rmvl bnd","description":"Closure of single ventricular septal defect, with or without patch; with removal of pulmonary artery band, with or without gusset","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29867","name":"Allgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E8002","name":"Anterior gait trainer","description":"Gait trainer, pediatric size, anterior support, includes all accessories and components","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96373","name":"Ther/proph/diag inj ia","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33405","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11602","name":"Exc tr-ext mal+marg 1.1-2 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2534.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87389","name":"Hiv-1 ag w/hiv-1&-2 ab ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hiv-1 antigen(s), with hiv-1 and hiv-2 antibodies, single resu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75564","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5183.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22318","name":"Treat odontoid fx w/o graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4250","name":"Urine reagent strips/tablets","description":"Urine test or reagent strips or tablets (100 tablets or strips)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36012","name":"Place catheter in vein","description":"Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44111","name":"Excision of bowel lesion(s)","description":"Excision of 1 or more lesions of small or large intestine not requiring anastomosis, exteriorization, or fistulization; multiple enterotomies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0420","name":"Ed svc ckd ind per session","description":"Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35606","name":"Bpg carotid-subclavian","description":"Bypass graft, with other than vein; carotid-subclavian","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27165","name":"Incision/fixation of femur","description":"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43227","name":"Esophagoscopy control bleed","description":"Esophagoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42330","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63055","name":"Decompress spinal cord thrc","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87329","name":"Giardia ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; giardia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1566.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25020","name":"Decompress forearm 1 space","description":"Decompression fasciotomy, forearm and/or wrist, flexor or extensor compartment; without debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82340","name":"Assay of calcium in urine","description":"Calcium; urine quantitative, timed specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78267","name":"Urea breath tst c-14 acquisj","description":"Urea breath test, c-14 (isotopic); acquisition for analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"40845","name":"Reconstruction of mouth","description":"Vestibuloplasty; complex (including ridge extension, muscle repositioning)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6005","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99460","name":"Init nb em per day hosp","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40701","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9615","name":"Urine specimen collect mult","description":"Catheterization for collection of specimen(s) (multiple patients)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44376","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40520","name":"Partial excision of lip","description":"Excision of lip; v-excision with primary direct linear closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27596","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; re-amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62116","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4553.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90817","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01951","name":"Anes 2&3 burn less 4 % tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; less than 4% total body surface area","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6558.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3255.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2217.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15774","name":"Gfrg autol fat lipo ea addl","description":"Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54512","name":"Excise lesion testis","description":"Excision of extraparenchymal lesion of testis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4978.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27712","name":"Osteot mlt relignmt imed rod","description":"Osteotomy; multiple, with realignment on intramedullary rod (eg, sofield type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31527","name":"Laryngoscopy for treatment","description":"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57296","name":"Revise vag graft open abd","description":"Revision (including removal) of prosthetic vaginal graft; open abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28107","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus; with allograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27364","name":"Resect thigh/knee tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99457","name":"Rpm tx mgmt 1st 20 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; first 20 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3222","name":"Mens shoes hightop depth inl","description":"Orthopedic footwear, mens shoe, hightop, depth inlay, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38746","name":"Remove thoracic lymph nodes","description":"Thoracic lymphadenectomy by thoracotomy, mediastinal and regional lymphadenectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35151","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0343","name":"Laparotomy islet cell transp","description":"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76886","name":"Us exam infant hips static","description":"Ultrasound, infant hips, real time with imaging documentation; limited, static (not requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27369","name":"Njx cntrst kne arthg/ct/mri","description":"Injection procedure for contrast knee arthrography or contrast enhanced ct/mri knee arthrography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50081","name":"Perq nl/pl lithotrp cplx>2cm","description":"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, co","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1760","name":"Closure dev, vasc","description":"Closure device, vascular (implantable/insertable)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0552T","name":"Low-level laser therapy","description":"Low-level laser therapy, dynamic photonic and dynamic thermokinetic energies, provided by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76885","name":"Us exam infant hips dynamic","description":"Ultrasound, infant hips, real time with imaging documentation; dynamic (requiring physician or other qualified health care professional manipulation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85460","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; differential lysis (kleihauer-betke)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0426","name":"Inpt/ed teleconsult50","description":"Telehealth consultation, emergency department or initial inpatient, typically 50 minutes communicating with the patient via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61611","name":"Transect artery sinus","description":"Transection or ligation, carotid artery in petrous canal; without repair (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3265.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35131","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery (common, hypogastric, external)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43284","name":"Laps esophgl sphnctr agmntj","description":"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43332","name":"Transab esoph hiat hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0243","name":"Toilet rail","description":"Toilet rail, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24105","name":"Excision olecranon bursa","description":"Excision, olecranon bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21141","name":"Rcnstj midface lefort i 1pc","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction (eg, for long face syndrome), without bone graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35741","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71040","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4721","name":"Dialysat sol fld vol > 999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20660","name":"Apply rem fixation device","description":"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30802","name":"Ablate inf turbinate submuc","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (ie, submucosal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22819","name":"Kyphectomy 3 or more","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0245","name":"Tub stool or bench","description":"Tub stool or bench","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29870","name":"Arthrs knee dx w/wo syn bx","description":"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43112","name":"Esphg tot w/thrcm","description":"Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical esophagogastrostomy, with or without pyloroplasty (ie, mckeown esophagectomy or tri-incisional esophagectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87486","name":"Chlmyd pneum dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13152","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43331","name":"Esophagomyotomy thoracic","description":"Esophagomyotomy (heller type); thoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26428","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33254","name":"Ablate atria lmtd","description":"Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27218","name":"Treat pelvic ring fracture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49442","name":"Place cecostomy tube perc","description":"Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45563","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury; with colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21247","name":"Reconstruct lower jaw bone","description":"Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38564","name":"Removal abdomen lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22865","name":"Rmvl tot arthrp 1ntrspc lmbr","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2064.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11620","name":"Exc h-f-nk-sp mal+marg 0.5/<","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32160","name":"Open chest heart massage","description":"Thoracotomy; with cardiac massage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21725","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; with cast application","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26500","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3649","name":"Orthopedic shoe modifica nos","description":"Orthopedic shoe, modification, addition or transfer, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54164","name":"Frenulotomy of penis","description":"Frenulotomy of penis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40820","name":"Treatment of mouth lesion","description":"Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91037","name":"Esoph imped function test","description":"Esophageal function test, gastroesophageal reflux test with nasal catheter intraluminal impedance electrode(s) placement, recording, analysis and interpretation;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62368","name":"Analyze sp inf pump w/reprog","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64486","name":"Tap block unil by injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27470","name":"Repair of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5233.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87910","name":"Nfct agt gntyp alys cmv","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); cytomegalovirus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"48552","name":"Prep donor pancreas/venous","description":"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"14060","name":"Tis trnfr e/n/e/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27386","name":"Repair/graft of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32661","name":"Thoracoscopy w/pericard exc","description":"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31636","name":"Bronchoscopy bronch stents","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93264","name":"Rem mntr wrls p-art prs snr","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days, including at least weekly downloads of pulmonary artery pressure recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88385","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35355","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliofemoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95081.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51940","name":"Correction of bladder defect","description":"Closure, exstrophy of bladder","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27752","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87498","name":"Enterovirus probe&revrs trns","description":"Infectious agent detection by nucleic acid (dna or rna); enterovirus, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95718","name":"Eeg phys/qhp 2-12 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of eeg recording; with video (veeg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53250","name":"Removal of urethra gland","description":"Excision of bulbourethral gland (cowpers gland)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54231","name":"Dynamic cavernosometry","description":"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17312","name":"Mohs addl stage","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), h","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1803.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44650","name":"Repair bowel fistula","description":"Closure of enteroenteric or enterocolic fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12018","name":"Rpr f/e/e/n/l/m >30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45130","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; perineal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61575","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2303.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51729","name":"Cystometrogram w/vp&up","description":"Complex cystometrogram (ie, calibrated electronic equipment); with voiding pressure studies (ie, bladder voiding pressure) and urethral pressure profile studies (ie, urethral closure pressure profile), any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45305","name":"Proctosigmoidoscopy w/bx","description":"Proctosigmoidoscopy, rigid; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61601","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31085","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15782","name":"Dermabrasion other than face","description":"Dermabrasion; regional, other than face","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45334","name":"Sigmoidoscopy for bleeding","description":"Sigmoidoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94260","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99354","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0293","name":"Hosp bed var ht no sr no mat","description":"Hospital bed, variable height, hi-lo, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95976","name":"Alys smpl cn npgt prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1462.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1494.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20693","name":"Adjmt/revj ext fixj sys anes","description":"Adjustment or revision of external fixation system requiring anesthesia (eg, new pin[s] or wire[s] and/or new ring[s] or bar[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72130","name":"Ct chest spine w/o & w/dye","description":"Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69905","name":"Remove inner ear","description":"Labyrinthectomy; transcanal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27257","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47135","name":"Transplantation of liver","description":"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54690","name":"Laparoscopy orchiectomy","description":"Laparoscopy, surgical; orchiectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0415","name":"Open tx post pelvic fxcture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64885","name":"Nerve graft head/neck <4 cm","description":"Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25125","name":"Remove/graft forearm lesion","description":"Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01968","name":"Anes/analg cs dlvr neuraxial","description":"Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93286","name":"Peri-px eval pm/ldls pm ip","description":"Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead pacemaker system, or leadless pacemaker ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21408","name":"Opn tx orbit fx w/bone grft","description":"Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B5100","name":"Parenteral solution hepatic","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, hepatic, hepatamine-premix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11621","name":"Exc s/n/h/f/g mal+mrg 0.6-1","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32402","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61791","name":"Treat trigeminal tract","description":"Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27447","name":"Total knee arthroplasty","description":"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"88331","name":"Path consltj surg 1 blk 1spc","description":"Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94370","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95832","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37222","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4810.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"81289","name":"Fxn gene known famil variant","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; known familial variant(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43887","name":"Gstr rstcv px opn rmvl port","description":"Gastric restrictive procedure, open; removal of subcutaneous port component only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36466","name":"Njx noncmpnd sclrsnt mlt vn","description":"Injection of non-compounded foam sclerosant with ultrasound compression maneuvers to guide dispersion of the injectate, inclusive of all imaging guidance and monitoring; multiple incompetent truncal veins (eg, great saphenous vein, accessory saphenous vein), same leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32650","name":"Thoracoscopy w/pleurodesis","description":"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93350","name":"Stress tte only","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50961","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23395","name":"Muscle transfer shoulder/arm","description":"Muscle transfer, any type, shoulder or upper arm; single","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50970","name":"Ureter endoscopy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28039","name":"Exc foot/toe tum sc 1.5 cm/>","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88112","name":"Cytopath cell enhance tech","description":"Cytopathology, selective cellular enhancement technique with interpretation (eg, liquid based slide preparation method), except cervical or vaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0103","name":"Psa screening","description":"Prostate cancer screening; prostate specific antigen test (psa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01652","name":"Anes art sho&ax ax-brch arsm","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-brachial aneurysm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70542","name":"Mri orbit/face/neck w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21497","name":"Interdental wirg oth/thn fx","description":"Interdental wiring, for condition other than fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58267","name":"Vag hyst w/urinary repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (marshall-marchetti-krantz type, pereyra type) with or without endoscopic control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60252","name":"Removal of thyroid","description":"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27886","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; re-amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69310","name":"Rebuild outer ear canal","description":"Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43122","name":"Partial removal of esophagus","description":"Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0274","name":"Over-bed table","description":"Over-bed table","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20150","name":"Excision epiphyseal bar","description":"Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61540","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43327","name":"Esoph fundoplasty lap","description":"Esophagogastric fundoplasty partial or complete; laparotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35236","name":"Repair blvsl vn grf uxtr","description":"Repair blood vessel with vein graft; upper extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44005","name":"Freeing of bowel adhesion","description":"Enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36582","name":"Replace tunneled cv cath","description":"Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31551","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, younger than 12 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50553","name":"Kidney endoscopy","description":"Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52010","name":"Cystoscopy & duct catheter","description":"Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33264","name":"Rmvl & rplcmt dfb gen mlt ld","description":"Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20902","name":"Removal of bone for graft","description":"Bone graft, any donor area; major or large","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66635","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; optical (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"56606","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); each separate additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42408","name":"Excision of salivary cyst","description":"Excision of sublingual salivary cyst (ranula)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11001","name":"Dbrdmt ecz/infct skn ea addl","description":"Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33273","name":"Repos prev impltbl subq dfb","description":"Repositioning of previously implanted subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23174","name":"Sqstrctmy humrl head srg nck","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61343","name":"Crnec sopl crv lam dcmprn","description":"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, arnold-chiari malformation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6549","name":"Grad com garm noc day use","description":"Gradient compression garment, not otherwise specified, for daytime use, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"Prev visit new age 40-64","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35548","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50600","name":"Exploration of ureter","description":"Ureterotomy with exploration or drainage (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36836","name":"Prq av fstl crtj uxtr 1 acs","description":"Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiolo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5609.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66710","name":"Ciliary transsleral therapy","description":"Ciliary body destruction; cyclophotocoagulation, transscleral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12041","name":"Intmd rpr n-hf/genit 2.5cm/<","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4706","name":"Bicarbonate conc sol per gal","description":"Bicarbonate concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81596","name":"Nfct ds chrnc hcv 6 assays","description":"Infectious disease, chronic hepatitis c virus (hcv) infection, six biochemical assays (alt, a2-macroglobulin, apolipoprotein a-1, total bilirubin, ggt, and haptoglobin) utilizing serum, prognostic algorithm reported as scores for fibrosis and necroinflammatory activity in liver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53040","name":"Drainage of urethra abscess","description":"Drainage of deep periurethral abscess","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2874.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93591","name":"Perq transcath cls aortic","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, aortic valve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70470","name":"Ct head/brain w/o & w/dye","description":"Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22533","name":"Arthrd lat xtrcvtry tq lmbr","description":"Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27218","name":"Treat pelvic ring fracture","description":"Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral, includes internal fixation, when performed (includes ipsilateral ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28295","name":"Cor hlx vlgs prx mtar osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal metatarsal osteotomy, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69710","name":"Implant/replace hearing aid","description":"Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83695","name":"Assay of lipoprotein(a)","description":"Lipoprotein (a)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0186","name":"Dstry eye lesn,fdr vssl tech","description":"Destruction of localized lesion of choroid (for example, choroidal neovascularization); photocoagulation, feeder vessel technique (one or more sessions)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0477","name":"Pwr module pt cable lvad rpl","description":"Power module patient cable for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26123","name":"Release palm contracture","description":"Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31051","name":"Sphenoid sinus surgery","description":"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82055","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63662","name":"Remove spine eltrd plate","description":"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3909.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP03","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35571","name":"Art byp pop-tibl-prl-other","description":"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15150","name":"Tis cltr skn agrft t/a/l 1st","description":"Tissue cultured skin autograft, trunk, arms, legs; first 25 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69421","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21016","name":"Resect face/scalp tum 2 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; 2 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3703.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1978.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64493","name":"Inj paravert f jnt l/s 1 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28740","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, single joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33965","name":"Ecmo/ecls rmvl perph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27550","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52630","name":"Remove prostate regrowth","description":"Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35091","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0239","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61781","name":"Scan proc cranial intra","description":"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49500","name":"Rpr ing hernia init reduce","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21501","name":"I&d dp absc/hmtma sft ts nck","description":"Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75573","name":"Ct hrt c+ strux cgen hrt ds","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3d image postprocessing, assessment of left ventricular [lv] cardiac function, right ventricular [rv] structure and function and evaluation of ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38210","name":"T-cell depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; specific cell depletion within harvest, t-cell depletion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43405","name":"Ligate/staple esophagus","description":"Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90969","name":"Esrd svc pr day pt 12-19","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 12-19 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80412","name":"Crh stimulation panel","description":"Corticotropic releasing hormone (crh) stimulation panel this panel must include the following: cortisol (82533 x 6) adrenocorticotropic hormone (acth) (82024 x 6)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62303","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61606","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2620.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01232","name":"Anes opn px upr 2/3 fem amp","description":"Anesthesia for open procedures involving upper two-thirds of femur; amputation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87528","name":"Hsv dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21452","name":"Perq tx mndblr fx xtrnl fixj","description":"Percutaneous treatment of mandibular fracture, with external fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0437","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94453","name":"Hast w/suppl oxygen titrj","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional; with supplemental oxygen titration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82615","name":"Test for urine cystines","description":"Cystine and homocystine, urine, qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21700","name":"Revision of neck muscle","description":"Division of scalenus anticus; without resection of cervical rib","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5225.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15821","name":"Blepharp lwr eyelid fat pad","description":"Blepharoplasty, lower eyelid; with extensive herniated fat pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84630","name":"Assay of zinc","description":"Zinc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94360","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80414","name":"Testosterone response panel","description":"Chorionic gonadotropin stimulation panel; testosterone response this panel must include the following: testosterone (84403 x 2 on 3 pooled blood samples)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42180","name":"Repair lac palate<2 cm","description":"Repair, laceration of palate; up to 2 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19281","name":"Perq device breast 1st imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42180","name":"Repair lac palate<2 cm","description":"Repair, laceration of palate; up to 2 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26727","name":"Treat finger fracture each","description":"Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"81210","name":"Braf gene","description":"Braf (b-raf proto-oncogene, serine/threonine kinase) (eg, colon cancer, melanoma), gene analysis, v600 variant(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27194","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26135","name":"Revise finger joint each","description":"Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43334","name":"Transthor diaphrag hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; without implantation of mesh or other prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["BA","KG","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58572","name":"Tlh uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36565","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (eg, tesio type catheter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87632","name":"Resp virus 6-11 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3455.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95060","name":"Oph mucous membrane tests","description":"Ophthalmic mucous membrane tests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87471","name":"Bartonella dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23077","name":"Rad rescj tum shoulder<5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of shoulder area; less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4895.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61640","name":"Dilate ic vasospasm init","description":"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"22858","name":"Tot disc arthrp 2nd lvl crv","description":"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); second level, cervical (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83857","name":"Assay of methemalbumin","description":"Methemalbumin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40842","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27086","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; subcutaneous tissue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4524","name":"Adult size brief/diaper xl","description":"Adult sized disposable incontinence product, brief/diaper, extra large, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10030","name":"Img gid flu coll drg sft tis","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50405","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61864","name":"Implant neuroelectrde addl","description":"Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use of intraoperative microelectrode recording; each additional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68328","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93786","name":"Ambl bp mntr w/sw rec only","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; recording only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49570","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95146","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 2 single stinging insect venoms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00560","name":"Anes px heart w/o pump oxtj","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26705","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28320","name":"Repair of foot bones","description":"Repair, nonunion or malunion; tarsal bones","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95700","name":"Eeg cont rec w/vid eeg tech","description":"Electroencephalogram (eeg) continuous recording, with video when performed, setup, patient education, and takedown when performed, administered in person by eeg technologist, minimum of 8 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0074A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55530","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31800","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34845","name":"Visc & infraren abd 1 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29715","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7529.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33275","name":"Tcat rmvl perm ldls pm w/img","description":"Transcatheter removal of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography), when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28605","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19302","name":"P-mastectomy w/ln removal","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87300","name":"Ag detection polyval if","description":"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95134","name":"Immntx 5 sting insects","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; 5 stinging insect venoms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4367.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4554","name":"Disposable underpads","description":"Disposable underpads, all sizes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62117","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining grafts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76826","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording; follow-up or repeat study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35483","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49566","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6025","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61595","name":"Transtemporal approach/skull","description":"Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"32998","name":"Ablate pulm tumor perq rf","description":"Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) including pleura or chest wall when involved by tumor extension, percutaneous, including imaging guidance when performed, unilateral; radiofrequency","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4540","name":"Reusable underpad chair size","description":"Incontinence product, protective underpad, reusable, chair size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1686.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99315","name":"Nf dschrg mgmt 30 min/less","description":"Nursing facility discharge management; 30 minutes or less total time on the date of the encounter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66680","name":"Repair iris & ciliary body","description":"Repair of iris, ciliary body (as for iridodialysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74246","name":"X-ray xm upr gi trc 2cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27181","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; osteotomy and internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72146","name":"Mri chest spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5536.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34701","name":"Evasc rpr a-ao ndgft","description":"Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35236","name":"Repair blvsl vn grf uxtr","description":"Repair blood vessel with vein graft; upper extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97608","name":"Neg prs wnd ther ndme>50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4531","name":"Ped size pull-on sm/med","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45397","name":"Lap remove rectum w/pouch","description":"Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, j-pouch), with diverting enterostomy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26497","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; ring and small finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94645","name":"Cont inhlj tx each addl hour","description":"Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61781","name":"Scan proc cranial intra","description":"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4671","name":"Disposable cycler set","description":"Disposable cycler set used with cycler dialysis machine, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24560","name":"Cltx hum epcndylr fx wo mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11055","name":"Paring/cutg b9 hyprker les 1","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72114","name":"X-ray exam l-s spine bending","description":"Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27178","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44128","name":"Enterectomy cong add-on","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24900","name":"Amputation of upper arm","description":"Amputation, arm through humerus; with primary closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00731","name":"Anes upr gi ndsc px nos","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55060","name":"Repair of hydrocele","description":"Repair of tunica vaginalis hydrocele (bottle type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278T","name":"Tempr","description":"Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1088","name":"Wheelchair lightweight det a","description":"High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23405","name":"Incision of tendon & muscle","description":"Tenotomy, shoulder area; single tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87335","name":"E coli 0157 ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; escherichia coli 0157","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0087","name":"Care man home care plan 60 m","description":"Comprehensive (60 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00529","name":"Anes clsd ch mediast&thrc w/","description":"Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49080","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0691","name":"Uvl pnl 2 sq ft or less","description":"Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86486","name":"Skin test unlisted antign ea","description":"Skin test; unlisted antigen, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75940","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93555","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80432","name":"Insulin suppression panel","description":"Insulin-induced c-peptide suppression panel this panel must include the following: insulin (83525) c-peptide (84681 x 5) glucose (82947 x 5)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25312","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2738.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32960","name":"Therapeutic pneumothorax","description":"Pneumothorax, therapeutic, intrapleural injection of air","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25270","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26145","name":"Tendon excision palm/finger","description":"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96374","name":"Ther/proph/diag inj iv push","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37201","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44960","name":"Appendectomy","description":"Appendectomy; for ruptured appendix with abscess or generalized peritonitis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11307","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00932","name":"Anes male gent compl amp pns","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0501T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86825","name":"Hla x-math non-cytotoxic","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); first serum sample or dilution","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27477","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33863","name":"Ascending aortic graft","description":"Ascending aorta graft, with cardiopulmonary bypass, with aortic root replacement using valved conduit and coronary reconstruction (eg, bentall)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"24140","name":"Partial exc bone humerus","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15120","name":"Splt agrft f/s/n/h/f/g/m 1st","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95130","name":"Immntx 1 sting insect","description":"Professional services for allergen immunotherapy in the office or institution of the prescribing physician or other qualified health care professional, including provision of allergenic extract; single stinging insect venom","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24331","name":"Flexor-plasty elbw w/advmnt","description":"Flexor-plasty, elbow (eg, steindler type advancement); with extensor advancement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49605","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with or without prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35494","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38209","name":"Wash harvest stem cells","description":"Transplant preparation of hematopoietic progenitor cells; thawing of previously frozen harvest, with washing, per donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80439","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 2 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99359","name":"Prolong serv w/o contact add","description":"Prolonged evaluation and management service before and/or after direct patient care; each additional 30 minutes (list separately in addition to code for prolonged service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36215","name":"Place catheter in artery","description":"Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76510","name":"Oph us dx b-scan&quan a-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan and quantitative a-scan performed during the same patient encounter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32670","name":"Thoracoscopy bilobectomy","description":"Thoracoscopy, surgical; with removal of two lobes (bilobectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90945","name":"Dialysis one evaluation","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies), with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54360","name":"Penis plastic surgery","description":"Plastic operation on penis to correct angulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33268","name":"Excl laa opn oth px any meth","description":"Exclusion of left atrial appendage, open, performed at the time of other sternotomy or thoracotomy procedure(s), any method (eg, excision, isolation via stapling, oversewing, ligation, plication, clip) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11044","name":"Dbrdmt bone 1st 20 sq cm/<","description":"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4775.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15835","name":"Exc excessive skin buttock","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27871","name":"Fusion of tibiofibular joint","description":"Arthrodesis, tibiofibular joint, proximal or distal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64872","name":"Subsequent repair of nerve","description":"Suture of nerve; requiring secondary or delayed suture (list separately in addition to code for primary neurorrhaphy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3461.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35286","name":"Rpr blvsl grf oth/th vn lxtr","description":"Repair blood vessel with graft other than vein; lower extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83518","name":"Immunoassay dipstick","description":"Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, single step method (eg, reagent strip)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46740","name":"Construction of absent anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64778","name":"Digit nerve surgery add-on","description":"Excision of neuroma; digital nerve, each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27615","name":"Resect leg/ankle tum < 5 cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25076","name":"Exc forearm tum deep < 3 cm","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11828.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2824.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78586","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31611","name":"Constj trachesophgl fstl","description":"Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (eg, voice button, blom-singer prosthesis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97814","name":"Acup 1/> w/estim ea addl 15","description":"Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 minutes of personal one-on-one contact with the patient, with insertion of needle(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4480","name":"Vabra aspirator","description":"Vabra aspirator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93455","name":"Coronary art/grft angio s&i","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injecti","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11107","name":"Incal bx skn ea sep/addl","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64448","name":"Njx aa&/strd fem nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76706","name":"Us abdl aorta screen aaa","description":"Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (aaa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26735","name":"Treat finger fracture each","description":"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32662","name":"Thoracoscopy w/mediast exc","description":"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61645","name":"Perq art m-thrombect &/nfs","description":"Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84512","name":"Assay of troponin qual","description":"Troponin, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92202","name":"Opscpy extnd on/mac draw","description":"Ophthalmoscopy, extended; with drawing of optic nerve or macula (eg, for glaucoma, macular pathology, tumor) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84410","name":"Testosterone bioavailable","description":"Testosterone; bioavailable, direct measurement (eg, differential precipitation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0885","name":"Pwc gp4 std mult pow opt cap","description":"Power wheelchair, group 4 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30462","name":"Revision of nose","description":"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87537","name":"Hiv-2 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4490","name":"Above knee surgical stocking","description":"Surgical stockings above knee length, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10071.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92998","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4927","name":"Non-sterile gloves","description":"Gloves, non-sterile, per 100","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24560","name":"Cltx hum epcndylr fx wo mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40800","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64590","name":"Ins/rpl prph sac/gstr npg/r","description":"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2061.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50400","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4657","name":"Syringe w/wo needle","description":"Syringe, with or without needle, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01740","name":"Anes opn/arthrs px elbw nos","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83887","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"12035","name":"Intmd rpr s/a/t/ext 12.6-20","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94452","name":"Hast w/i&r phys/qhp","description":"High altitude simulation test (hast), with interpretation and report by a physician or other qualified health care professional;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24420","name":"Osteoplasty humerus","description":"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27503","name":"Treatment of thigh fracture","description":"Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95800","name":"Slp stdy unattended","description":"Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61770","name":"Incise skull for treatment","description":"Stereotactic localization, including burr hole(s), with insertion of catheter(s) or probe(s) for placement of radiation source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55550","name":"Laparo ligate spermatic vein","description":"Laparoscopy, surgical, with ligation of spermatic veins for varicocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92602","name":"Reprogram cochlear implt <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88312","name":"Special stains group 1","description":"Special stain including interpretation and report; group i for microorganisms (eg, acid fast, methenamine silver)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49180","name":"Biopsy abdominal mass","description":"Biopsy, abdominal or retroperitoneal mass, percutaneous needle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64448","name":"Njx aa&/strd fem nrv nfs img","description":"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, continuous infusion by catheter (including catheter placement), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27756","name":"Treatment of tibia fracture","description":"Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1841","name":"Sps/pass shoulder device","description":"Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4841.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25415","name":"Repair radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; without graft (eg, compression technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11771","name":"Exc pilonidal cyst xtnsv","description":"Excision of pilonidal cyst or sinus; extensive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11442","name":"Exc face-mm b9+marg 1.1-2 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23410","name":"Repair rotator cuff acute","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36838","name":"Dist revas ligation hemo","description":"Distal revascularization and interval ligation (dril), upper extremity hemodialysis access (steal syndrome)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70555","name":"Fmri brain by phys/psych","description":"Magnetic resonance imaging, brain, functional mri; requiring physician or psychologist administration of entire neurofunctional testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34703","name":"Evasc rpr a-unilac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in th","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80157","name":"Assay carbamazepine free","description":"Carbamazepine; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26992","name":"Drainage of bone lesion","description":"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92605","name":"Ex for nonspeech device rx","description":"Evaluation for prescription of non-speech-generating augmentative and alternative communication device, face-to-face with the patient; first hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9552","name":"F18 fdg","description":"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21552","name":"Exc neck les sc 3 cm/>","description":"Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93539","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38120","name":"Laparoscopy splenectomy","description":"Laparoscopy, surgical, splenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99172","name":"Ocular function screen","description":"Visual function screening, automated or semi-automated bilateral quantitative determination of visual acuity, ocular alignment, color vision by pseudoisochromatic plates, and field of vision (may include all or some screening of the determination[s] for contrast sensitivity, vision under glare)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22630","name":"Arthrd pst tq 1ntrspc lum","description":"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88360","name":"Tumor immunohistochem/manual","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; manual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77317","name":"Brachytx isodose intermed","description":"Brachytherapy isodose plan; intermediate (calculation[s] made from 5 to 10 sources, or remote afterloading brachytherapy, 2-12 channels), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24341","name":"Rpr tdn/musc upr a/e each","description":"Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86806","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; without titration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66175","name":"Trluml dil aq o/f can w/st","description":"Transluminal dilation of aqueous outflow canal (eg, canaloplasty); with retention of device or stent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4808.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35492","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61535","name":"Remove brain electrodes","description":"Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49440","name":"Place gastrostomy tube perc","description":"Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93281","name":"Pm device progr eval multi","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86831","name":"Hla class ii phenotype qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); antibody identification by qualitative panel using complete hla phenotypes, hla class ii","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93892","name":"Tcd emboli detect w/o inj","description":"Transcranial doppler study of the intracranial arteries; emboli detection without intravenous microbubble injection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46751","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; child","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27846","name":"Treat ankle dislocation","description":"Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43277","name":"Ercp ea duct/ampulla dilate","description":"Endoscopic retrograde cholangiopancreatography (ercp); with trans-endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, each duct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64626","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72127","name":"Ct neck spine w/o & w/dye","description":"Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95717","name":"Eeg phys/qhp 2-12 hr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation and report, 2-12 hours of eeg recording; without video","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4103","name":"Ef ped fluid and electrolyte","description":"Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25450","name":"Epiphysl arrst dstl rds/ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius or ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22585","name":"Arthrd ant ntrbd min dsc ea","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15156","name":"Tis clt agrft f/s/n/h/f/g ad","description":"Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85335","name":"Factor inhibitor test","description":"Factor inhibitor test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52346","name":"Cystouretero w/renal strict","description":"Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86860","name":"Rbc antibody elution","description":"Antibody elution (rbc), each elution","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4714","name":"Treated water per gallon","description":"Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0148T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78815","name":"Pet image w/ct skull-thigh","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; skull base to mid-thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52442","name":"Cysto ins trnsprstc implt ea","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; each additional permanent adjustable transprostatic implant (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88248","name":"Chromosome analysis 50-100","description":"Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, fanconi anemia, fragile x)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28456","name":"Prq skel fix tarsl fx w/mnpj","description":"Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77001","name":"Fluoroguide for vein device","description":"Fluoroscopic guidance for central venous access device placement, replacement (catheter only or complete), or removal (includes fluoroscopic guidance for vascular access and catheter manipulation, any necessary contrast injections through access site or catheter with related venography radiologic su","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62287","name":"Dcmprn pq nuc pul 1/mlt lmbr","description":"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, sing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1712.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43101","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50045","name":"Nephrotomy w/exploration","description":"Nephrotomy, with exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99491","name":"Chrnc care mgmt phys 1st 30","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35741","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13132","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4248","name":"Chlorhexidine antisept","description":"Chlorhexidine containing antiseptic, 1 ml","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63001","name":"Remove spine lamina 1/2 crvl","description":"Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"22854","name":"Insj biomechanical device","description":"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrod","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43338","name":"Esoph lengthening","description":"Esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92340","name":"Fit spectacles monofocal","description":"Fitting of spectacles, except for aphakia; monofocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2994.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73219","name":"Mri upper extremity w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44392","name":"Colonoscopy & polypectomy","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61490","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92083","name":"Extended visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 deg, or quantitative, automated threshold perimetry, octopus program g-1, 32 or 42, hump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90887","name":"Interpj/explnaj rslt psyc xm","description":"Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33235","name":"Removal pacemaker electrode","description":"Removal of transvenous pacemaker electrode(s); dual lead system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1631.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2426.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1913.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00794","name":"Anes iper upr abd pncrtect","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, whipple procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92523","name":"Speech sound lang comprehen","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria); with evaluation of language comprehension and expression (eg, receptive and expressive language)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4154","name":"Ef spec metabolic noninherit","description":"Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8750.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78265","name":"Gstr emptg img sm bwl trnst","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel transit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8900","name":"Mra w/cont, abd","description":"Magnetic resonance angiography with contrast, abdomen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0503","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69720","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; lateral to geniculate ganglion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95978","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88120","name":"Cytp urne 3-5 probes ea spec","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92564","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0174T","name":"Cad cxr with interp","description":"Computer-aided detection (cad) (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation and report, with or without digitization of film radiographic images, chest radiograph(s), performed concurrent with primary interpretation (list s","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86781","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0130","name":"Single energy x-ray study","description":"Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01522","name":"Anes px vn lwr leg ven thrmb","description":"Anesthesia for procedures on veins of lower leg; venous thrombectomy, direct or with catheter","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72147","name":"Mri chest spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64580","name":"Opn impltj nea neuromuscular","description":"Open implantation of neurostimulator electrode array; neuromuscular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99184","name":"Hypothermia ill neonate","description":"Initiation of selective head or total body hypothermia in the critically ill neonate, includes appropriate patient selection by review of clinical, imaging and laboratory data, confirmation of esophageal temperature probe location, evaluation of amplitude eeg, supervision of controlled hypothermia, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27495","name":"Reinforce thigh","description":"Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0482","name":"Drug test def 15-21 classes","description":"Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5225.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27676","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; with fibular osteotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9615","name":"Urine specimen collect mult","description":"Catheterization for collection of specimen(s) (multiple patients)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27048","name":"Exc hip/pelv tum deep < 5 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4146.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16036","name":"Escharotomy ea addl incision","description":"Escharotomy; each additional incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2285.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87101","name":"Skin fungi culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0504T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50592","name":"Perc rf ablate renal tumor","description":"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86753","name":"Protozoa antibody nos","description":"Antibody; protozoa, not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96164","name":"Hlth bhv ivntj grp 1st 30","description":"Health behavior intervention, group (2 or more patients), face-to-face; initial 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93314","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); image acquisition, interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6233.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32554","name":"Aspirate pleura w/o imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57265","name":"Cmbn ap colprhy w/ntrcl rpr","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35566","name":"Art byp fem-ant-post tib/prl","description":"Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or other distal vessels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21936","name":"Resect back tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of back or flank; 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"13102","name":"Cmplx rpr trunk addl 5cm/<","description":"Repair, complex, trunk; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64752","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27422","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, campbell, goldwaite type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92325","name":"Modification of contact lens","description":"Modification of contact lens (separate procedure), with medical supervision of adaptation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95872","name":"Ndl emg single fiber eltrd","description":"Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64744","name":"Incise nerve back of head","description":"Transection or avulsion of; greater occipital nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77767","name":"Hdr rdncl skn surf brachytx","description":"Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed; lesion diameter up to 2.0 cm or 1 channel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3729.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00410","name":"Anes integ sys conv arrhyt","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47533","name":"Plmt biliary drainage cath","description":"Placement of biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; external","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95924","name":"Ans parasymp & symp w/tilt","description":"Testing of autonomic nervous system function; combined parasympathetic and sympathetic adrenergic function testing with at least 5 minutes of passive tilt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27511","name":"Treatment of thigh fracture","description":"Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24301","name":"Musc/tdn transfer upr a/e 1","description":"Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75574","name":"Ct angio hrt w/3d image","description":"Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3d image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73503","name":"X-ray exam hip uni 4/> views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01941","name":"Anes neuromd/ntrvrt crv/thrc","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93982","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61597","name":"Transcondylar approach/skull","description":"Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of c1-c3 vertebral body(s), decompression of vertebral artery, with or without mobilization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27768","name":"Cltx post ankle fx w/mnpj","description":"Closed treatment of posterior malleolus fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87385","name":"Histoplasma capsul ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; histoplasma capsulatum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6512","name":"Compres burn garment, noc","description":"Compression burn garment, not otherwise classified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76815","name":"Ob us limited fetus(s)","description":"Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A7042","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50542","name":"Laparo ablate renal mass","description":"Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54406","name":"Remove muti-comp penis pros","description":"Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21454","name":"Optx mndblr fx xtrnl fixj","description":"Open treatment of mandibular fracture with external fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11601","name":"Exc tr-ext mal+marg 0.6-1 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29710","name":"Rmvl/bivlv sho/hip spica","description":"Removal or bivalving; shoulder or hip spica, minerva, or risser jacket, etc.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81314","name":"Pdgfra gene","description":"Pdgfra (platelet-derived growth factor receptor, alpha polypeptide) (eg, gastrointestinal stromal tumor [gist]), gene analysis, targeted sequence analysis (eg, exons 12, 18)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99201","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94669","name":"Mechanical chest wall oscill","description":"Mechanical chest wall oscillation to facilitate lung function, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95783","name":"Polysom <6 yrs cpap/bilvl","description":"Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2251","name":"Brief chkin, 5-10, non-e/m","description":"Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service o","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43212","name":"Esophagoscop stent placement","description":"Esophagoscopy, flexible, transoral; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11400","name":"Exc tr-ext b9+marg 0.5 cm<","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78814","name":"Pet image w/ct lmtd","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11010","name":"Debride skin at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45388","name":"Colonoscopy w/ablation","description":"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28124","name":"Partial removal of toe","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); phalanx of toe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11042","name":"Dbrdmt subq tis 1st 20sqcm/<","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0027","name":"Semen analysis","description":"Semen analysis; presence and/or motility of sperm excluding huhner","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36140","name":"Intro ndl icath upr/lxtr art","description":"Introduction of needle or intracatheter, upper or lower extremity artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0079","name":"Care manag h vst new pt 60 m","description":"Comprehensive (60 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23675","name":"Cltx sho dislc neck fx mnpj","description":"Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75630","name":"X-ray aorta leg arteries","description":"Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84127","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99152","name":"Mod sed same phys/qhp 5/>yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20696","name":"App mltpln uni xtrnl fix 1st","description":"Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64804","name":"Sympathectomy cervicothorac","description":"Sympathectomy, cervicothoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64821","name":"Sympathectomy radial artery","description":"Sympathectomy; radial artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99219","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72270","name":"Myelogphy 2/> spine regions","description":"Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24586","name":"Optx partclr fx&/dislc elbow","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10036","name":"Plmt sft tiss loclzj dev ea","description":"Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88333","name":"Path consltj surg cyto xm 1","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), initial site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86343","name":"Leukocyte histamine release","description":"Leukocyte histamine release test (lhr)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93724","name":"Elec alys antitchycar pm sys","description":"Electronic analysis of antitachycardia pacemaker system (includes electrocardiographic recording, programming of device, induction and termination of tachycardia via implanted pacemaker, and interpretation of recordings)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33519","name":"Cabg artery-vein three","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 3 venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92310","name":"Contact lens fitting ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27161","name":"Incision of neck of femur","description":"Osteotomy, femoral neck (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0540T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0296T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"22850","name":"Remove spine fixation device","description":"Removal of posterior nonsegmental instrumentation (eg, harrington rod)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77316","name":"Brachytx isodose plan simple","description":"Brachytherapy isodose plan; simple (calculation[s] made from 1 to 4 sources, or remote afterloading brachytherapy, 1 channel), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8911","name":"Mra w/o fol w/cont, chest","description":"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31578","name":"Largsc w/removal lesion","description":"Laryngoscopy, flexible; with removal of lesion(s), non-laser","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21720","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; without cast application","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1801","name":"Sps/pass elbow device","description":"Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30468","name":"Rpr nsl vlv collapse w/implt","description":"Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43201","name":"Esoph scope w/submucous inj","description":"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62268","name":"Drain spinal cord cyst","description":"Percutaneous aspiration, spinal cord cyst or syrinx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0871","name":"Pwc gp 4 vhd seat/back","description":"Power wheelchair, group 4 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"Off/op cnsltj new/est low 30","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6806.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75563","name":"Card mri w/stress img & dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences; with stress imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25442","name":"Arthrp w/prostc dstl ulna","description":"Arthroplasty with prosthetic replacement; distal ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3942.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4610.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92993","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29851","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; with internal or external fixation (includes arthroscopy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9612","name":"Catheterize for urine spec","description":"Catheterization for collection of specimen, single patient, all places of service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33966","name":"Ecmo/ecls rmvl prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80176","name":"Assay of lidocaine","description":"Lidocaine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27486","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; 1 component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64570","name":"Remove vagus n eltrd","description":"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64634","name":"Destroy c/th facet jnt addl","description":"Destruction by neurolytic agent, paravertebral facet joint nerve(s), with imaging guidance (fluoroscopy or ct); cervical or thoracic, each additional facet joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"11056","name":"Parng/cutg b9 hyprkr les 2-4","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33427","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54220","name":"Irrg crpra cavrnosa priapism","description":"Irrigation of corpora cavernosa for priapism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86000","name":"Agglutinins febrile antigen","description":"Agglutinins, febrile (eg, brucella, francisella, murine typhus, q fever, rocky mountain spotted fever, scrub typhus), each antigen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87449","name":"Nos each organism ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; not otherwise specified, each organism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27327","name":"Exc thigh/knee les sc < 3 cm","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69670","name":"Remove mastoid air cells","description":"Mastoid obliteration (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92284","name":"Dx dark adaptation exam i&r","description":"Diagnostic dark adaptation examination (eg, rod and cone sensitivities, rod-cone breakpoint), with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76937","name":"Us guide vascular access","description":"Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting (list separately in addition to code for primary ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1093","name":"Wheelchair wide w/ foot rest","description":"Wide heavy duty wheelchair, detachable arms desk or full length arms, swing away detachable footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57461","name":"Conz of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0886","name":"Pwc gp4 hd mult pow s/b","description":"Power wheelchair, group 4 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0493T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61875","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0288","name":"Recon, cta for surg plan","description":"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66825","name":"Reposition intraocular lens","description":"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"85597","name":"Phospholipid pltlt neutraliz","description":"Phospholipid neutralization; platelet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93268","name":"Ecg record/review","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; includes transmission, review and interpretation by a physician or other qualified hea","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88302","name":"Tissue exam by pathologist","description":"Level ii - surgical pathology, gross and microscopic examination appendix, incidental fallopian tube, sterilization fingers/toes, amputation, traumatic foreskin, newborn hernia sac, any location hydrocele sac nerve skin, plastic repair sympathetic ganglion testis, castration vaginal mucosa, incident","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93631","name":"Ntraop epicar&endcar pac&map","description":"Intra-operative epicardial and endocardial pacing and mapping to localize the site of tachycardia or zone of slow conduction for surgical correction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6473.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"Esrd serv 4 vsts p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 4 or more face-to-face visits by a physician or other qualified health care professional ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63199","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15951","name":"Exc trchntr pr ulc ostc","description":"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92615","name":"Laryngoscopic sensory i&r","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording; interpretation and report only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36591","name":"Draw blood off venous device","description":"Collection of blood specimen from a completely implantable venous access device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43600","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11406","name":"Exc tr-ext b9+marg >4.0 cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43775","name":"Lap sleeve gastrectomy","description":"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92579","name":"Visual audiometry (vra)","description":"Visual reinforcement audiometry (vra)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1553.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62280","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; subarachnoid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2910.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35551","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01931","name":"Anes ivnt rad ntrhpt/prt crc","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrahepatic or portal circulation (eg, transvenous intrahepatic portosystemic shunt[s] [tips])","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87552","name":"Mycobacteria dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52647","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2800.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75989","name":"Abscess drainage under x-ray","description":"Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for percutaneous drainage (eg, abscess, specimen collection), with placement of catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37237","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75571","name":"Ct hrt w/o dye w/ca test","description":"Computed tomography, heart, without contrast material, with quantitative evaluation of coronary calcium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49565","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4500","name":"Below knee surgical stocking","description":"Surgical stockings below knee length, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1914.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93924","name":"Lwr xtr vasc stdy bilat","description":"Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing, (ie, bidirectional doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a st","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27827","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67570","name":"Decompress optic nerve","description":"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26593","name":"Release muscles of hand","description":"Release, intrinsic muscles of hand, each muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63615","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61537","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96153","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11308","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45393","name":"Colonoscopy w/decompression","description":"Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76882","name":"Us lmtd jt/fcl evl nvasc xtr","description":"Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft-tissue structure[s], or soft-tissue mass[es]), real-time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63271","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33534","name":"Cabg arterial two","description":"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24615","name":"Optx aqt/chrnc elbow dislc","description":"Open treatment of acute or chronic elbow dislocation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87338","name":"Hpylori stool ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; helicobacter pylori, stool","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34833","name":"Opn ilac art expos cndt crtj","description":"Open iliac artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by abdominal or retroperitoneal incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78429","name":"Myocrd img pet 1 std w/ct","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study; with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93017","name":"Cv stress test tracing only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93566","name":"Njx car cth slctv rv/ra ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36902","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83491","name":"Asy hydroxycorticosteroids17","description":"Hydroxycorticosteroids, 17- (17-ohcs)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86821","name":"Lymphocyte culture mixed","description":"Hla typing; lymphocyte culture, mixed (mlc)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80420","name":"Dexamethasone panel","description":"Dexamethasone suppression panel, 48 hour this panel must include the following: free cortisol, urine (82530 x 2) cortisol (82533 x 2) volume measurement for timed collection (81050 x 2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67228","name":"Treatment x10sv retinopathy","description":"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61108","name":"Tdh pnxr evac&/drg sdrl hmta","description":"Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for evacuation and/or drainage of subdural hematoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25320","name":"Repair/revise wrist joint","description":"Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, tendon transfer or graft) (includes synovectomy, capsulotomy and open reduction) for carpal instability","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11470","name":"Exc skn h/p/p/u smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10359.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36482","name":"Endoven ther chem adhes 1st","description":"Endovenous ablation therapy of incompetent vein, extremity, by transcatheter delivery of a chemical adhesive (eg, cyanoacrylate) remote from the access site, inclusive of all imaging guidance and monitoring, percutaneous; first vein treated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92640","name":"Aud brainstem implt programg","description":"Diagnostic analysis with programming of auditory brainstem implant, per hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2910.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24650","name":"Cltx rdl head/nck fx wo mnpj","description":"Closed treatment of radial head or neck fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11977","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49325","name":"Lap revision perm ip cath","description":"Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula or catheter, with removal of intraluminal obstructive material if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84112","name":"Eval amniotic fluid protein","description":"Evaluation of cervicovaginal fluid for specific amniotic fluid protein(s) (eg, placental alpha microglobulin-1 [pamg-1], placental protein 12 [pp12], alpha-fetoprotein), qualitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77417","name":"Ther radiology port image(s)","description":"Therapeutic radiology port image(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73223","name":"Mri joint upr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27497","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor); with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4168","name":"Parenteral sol amino acid 3.","description":"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36576","name":"Repair tunneled cv cath","description":"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1184.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64640","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; other peripheral nerve or branch","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22511","name":"Perq lumbosacral injection","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78816","name":"Pet image w/ct full body","description":"Positron emission tomography (pet) with concurrently acquired computed tomography (ct) for attenuation correction and anatomical localization imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2596.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1311.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"93529","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33780","name":"Rpr tga rcnstj clsr vsd","description":"Repair of transposition of the great arteries, aortic pulmonary artery reconstruction (eg, jatene type); with closure of ventricular septal defect","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38770","name":"Remove pelvis lymph nodes","description":"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92340","name":"Fit spectacles monofocal","description":"Fitting of spectacles, except for aphakia; monofocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64913","name":"Nrv rpr w/nrv algrft ea addl","description":"Nerve repair; with nerve allograft, each additional strand (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82540","name":"Assay of creatine","description":"Creatine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9980","name":"Remote e/m new pt 30 mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58146","name":"Myomectomy abdom complex","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0278","name":"Iliac art angio,cardiac cath","description":"Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, inj","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65112","name":"Remove eye/revise socket","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; with therapeutic removal of bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50340","name":"Recipient nephrectomy","description":"Recipient nephrectomy (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4456.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0398T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36120","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36906","name":"Thrmbc/nfs dialysis circuit","description":"Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thromboly","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33241","name":"Remove pulse generator","description":"Removal of implantable defibrillator pulse generator only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9560","name":"Tc99m labeled rbc","description":"Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38790","name":"Inject for lymphatic x-ray","description":"Injection procedure; lymphangiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29822","name":"Sho arthrs srg lmtd dbrdmt","description":"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44300","name":"Open bowel to skin","description":"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"96121","name":"Nubhvl xm phy/qhp ea addl hr","description":"Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15003","name":"Wound prep addl 100 cm","description":"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50400","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0111","name":"Wet mounts/ w preparations","description":"Wet mounts, including preparations of vaginal, cervical or skin specimens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1582.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43496","name":"Free jejunum flap microvasc","description":"Free jejunum transfer with microvascular anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3438.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40814","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19298","name":"Place breast rad tube/caths","description":"Placement of radiotherapy after loading brachytherapy catheters (multiple tube and button type) into the breast for interstitial radioelement application following (at the time of or subsequent to) partial mastectomy, includes imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7866.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29916","name":"Hip arthro w/labral repair","description":"Arthroscopy, hip, surgical; with labral repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87329","name":"Giardia ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; giardia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0432","name":"Eia hiv-1/hiv-2 screen","description":"Infectious agent antibody detection by enzyme immunoassay (eia) technique, hiv-1 and/or hiv-2, screening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43326","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33822","name":"Repair pda div<18 years","description":"Repair of patent ductus arteriosus; by division, younger than 18 years","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2008","name":"Post-d/c h vst ext pt 45 m","description":"Moderate (45 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient fac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80162","name":"Assay of digoxin total","description":"Digoxin; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63661","name":"Remove spine eltrd perq aray","description":"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60271","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; cervical approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87652","name":"Strep a dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69637","name":"Rebuild eardrum structures","description":"Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91117","name":"Colon motility 6 hr study","description":"Colon motility (manometric) study, minimum 6 hours continuous recording (including provocation tests, eg, meal, intracolonic balloon distension, pharmacologic agents, if performed), with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2025","name":"Dis site tele svcs rhc/fqhc","description":"Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33610","name":"Repair by enlargement","description":"Repair of complex cardiac anomalies (eg, single ventricle with subaortic obstruction) by surgical enlargement of ventricular septal defect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81003","name":"Urinalysis auto w/o scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95249","name":"Cont gluc mntr pt prov eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; patient-provided equipment, sensor placement, hook-up, calibration of monitor, patient training, and printout of recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35665","name":"Bpg iliofemoral","description":"Bypass graft, with other than vein; iliofemoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15241","name":"Fth/gft f/c/c/m/n/a/g/h/f ea","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33736","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; open heart with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43510","name":"Surgical opening of stomach","description":"Gastrotomy; with esophageal dilation and insertion of permanent intraluminal tube (eg, celestin or mousseaux-barbin)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25301","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; extensors of fingers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69433","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99355","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96020","name":"Functional brain mapping","description":"Neurofunctional testing selection and administration during noninvasive imaging functional brain mapping, with test administered entirely by a physician or other qualified health care professional (ie, psychologist), with review of test results and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70488","name":"Ct maxillofacial w/o & w/dye","description":"Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29885","name":"Arthrs kne srg drlg ost diss","description":"Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68500","name":"Removal of tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63600","name":"Remove spinal cord lesion","description":"Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86079","name":"Phys blood bank serv authrj","description":"Blood bank physician services; authorization for deviation from standard blood banking procedures (eg, use of outdated blood, transfusion of rh incompatible units), with written report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46922","name":"Excision of anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99082","name":"Unusual physician travel","description":"Unusual travel (eg, transportation and escort of patient)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76814","name":"Ob us nuchal meas add-on","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4337.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0425","name":"Inpt/ed teleconsult30","description":"Telehealth consultation, emergency department or initial inpatient, typically 30 minutes communicating with the patient via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20525","name":"Rmvl fb musc/tdn deep/comp","description":"Removal of foreign body in muscle or tendon sheath; deep or complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":841.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43320","name":"Fuse esophagus & stomach","description":"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77408","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86664","name":"Epstein-barr nuclear antigen","description":"Antibody; epstein-barr (eb) virus, nuclear antigen (ebna)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35683","name":"Composite byp grft 3/> segmt","description":"Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more locations (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30801","name":"Ablate inf turbinate superf","description":"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, electrocautery, radiofrequency ablation, or tissue volume reduction); superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92981","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93290","name":"Interrog dev eval icpms ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more reco","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65875","name":"Incise inner eye adhesions","description":"Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99480","name":"Sbsq ic inf pbw 2,501-5,000","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering infant (present body weight of 2,501-5,000 grams)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62325","name":"Njx interlaminar crv/thrc","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thorac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93620","name":"Comp ep evl r at ven pac&rec","description":"Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33952","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4765","name":"Dialysate conc pow per pack","description":"Dialysate concentrate, powder, additive for peritoneal dialysis, per packet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35271","name":"Rpr blvs gr ot/th vn ntrth w","description":"Repair blood vessel with graft other than vein; intrathoracic, with bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63302","name":"Remove vert xdrl body thrlmb","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28312","name":"Revision of toe","description":"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5546.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21147","name":"Rcnstj mdfc lefort i 3/>grf","description":"Reconstruction midface, lefort i; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33403","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9502","name":"Tc99m tetrofosmin","description":"Technetium tc-99m tetrofosmin, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74283","name":"Ther nma rdctj intus/obstrcj","description":"Therapeutic enema, contrast or air, for reduction of intussusception or other intraluminal obstruction (eg, meconium ileus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27337","name":"Exc thigh/knee les sc 3 cm/>","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15331","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0312","name":"Immunize couns < 21yr 5-15 m","description":"Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4676.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"Prev visit est age 1-4","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37237","name":"Open/perq place stent ea add","description":"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33681","name":"Closure 1 vsd w/wo patch","description":"Closure of single ventricular septal defect, with or without patch;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"48540","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; roux-en-y","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49605","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with or without prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4188.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69633","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99226","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20962","name":"Other bone graft microvasc","description":"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"34845","name":"Visc & infraren abd 1 prosth","description":"Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1683.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5376.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71550","name":"Mri chest w/o dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"41019","name":"Place needles h&n for rt","description":"Placement of needles, catheters, or other device(s) into the head and/or neck region (percutaneous, transoral, or transnasal) for subsequent interstitial radioelement application","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54435","name":"Revision of penis","description":"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, winter procedure, rongeur, or punch) for priapism","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87341","name":"Hep b surface ag neutrlzj ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis b surface antigen (hbsag) neutralization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0179","name":"Md recertification hha pt","description":"Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55725","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75984","name":"Xray control catheter change","description":"Change of percutaneous tube or drainage catheter with contrast monitoring (eg, genitourinary system, abscess), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54410","name":"Remove/replace penis prosth","description":"Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33877","name":"Thoracoabdominal graft","description":"Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67935","name":"Repair eyelid wound","description":"Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93351","name":"Stress tte complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"41140","name":"Removal of tongue","description":"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84591","name":"Assay of nos vitamin","description":"Vitamin, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93456","name":"R hrt coronary artery angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90868","name":"Tcranial magn stim tx deli","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent delivery and management, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82495","name":"Assay of chromium","description":"Chromium","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19306","name":"Mast rad urban type","description":"Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (urban type operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93529","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21401","name":"Closed tx orbit w/manipulj","description":"Closed treatment of fracture of orbit, except blowout; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55920","name":"Place needles pelvic for rt","description":"Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92519","name":"Vemp tst i&r cervical&ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp) and ocular (ovemp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82306","name":"Vitamin d 25 hydroxy","description":"Vitamin d; 25 hydroxy, includes fraction(s), if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61150","name":"Bur hol/trph drg brn abs/cst","description":"Burr hole(s) or trephine; with drainage of brain abscess or cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64772","name":"Incision of spinal nerve","description":"Transection or avulsion of other spinal nerve, extradural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97551","name":"Caregiver traing ea addl 15","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3870.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93564","name":"Njx cgen car cath slctv opac","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aortocoronary saphenous vein, free radial artery, or free mammary artery graft) to one or more coronary a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75774","name":"Artery x-ray each vessel","description":"Angiography, selective, each additional vessel studied after basic examination, radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90813","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82952","name":"Gtt-added samples","description":"Glucose; tolerance test, each additional beyond 3 specimens (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0113","name":"Cranial cervical torticollis","description":"Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96161","name":"Caregiver health risk assmt","description":"Administration of caregiver-focused health risk assessment instrument (eg, depression inventory) for the benefit of the patient, with scoring and documentation, per standardized instrument","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21195","name":"Reconst lwr jaw w/o fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31255","name":"Nsl/sins ndsc w/tot ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6018","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33852","name":"Rpr hypopl a-arch wo byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19081","name":"Bx breast 1st lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36576","name":"Repair tunneled cv cath","description":"Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33506","name":"Repair artery translocation","description":"Repair of anomalous coronary artery from pulmonary artery origin; by translocation from pulmonary artery to aorta","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82491","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87517","name":"Hepatitis b dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24344","name":"Reconstruct elbow lat ligmnt","description":"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67101","name":"Repair detached retina crtx","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57220","name":"Revision of urethra","description":"Plastic operation on urethral sphincter, vaginal approach (eg, kelly urethral plication)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25260","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28289","name":"Corrj halux rigdus w/o implt","description":"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15826","name":"Rhytidectomy glblr frn lines","description":"Rhytidectomy; glabellar frown lines","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0269","name":"Occlusive device in vein art","description":"Placement of occlusive device into either a venous or arterial access site, post surgical or interventional procedure (e.g., angioseal plug, vascular plug)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88332","name":"Path consltj surg ea add blk","description":"Pathology consultation during surgery; each additional tissue block with frozen section(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32098","name":"Open biopsy of lung pleura","description":"Thoracotomy, with biopsy(ies) of pleura","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64566","name":"Neuroeltrd stim post tibial","description":"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66250","name":"Follow-up surgery of eye","description":"Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94776","name":"Ped home apnea mntr dl&alys","description":"Pediatric home apnea monitoring event recording including respiratory rate, pattern and heart rate per 30-day period of time; monitoring, download of information, receipt of transmission(s) and analyses by computer only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22595","name":"Arthrd pst tq atlas-axis","description":"Arthrodesis, posterior technique, atlas-axis (c1-c2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0427","name":"Inpt/ed teleconsult70","description":"Telehealth consultation, emergency department or initial inpatient, typically 70 minutes or more communicating with the patient via telehealth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64405","name":"Njx aa&/strd gr ocpl nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2072.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86023","name":"Immunoglobulin assay","description":"Antibody identification; platelet associated immunoglobulin assay","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53515","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32096","name":"Open wedge/bx lung infiltr","description":"Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93641","name":"Ep evl 1/2chmb pac cvdfb tst","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement; with testing of single ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15789","name":"Chemical peel facial dermal","description":"Chemical peel, facial; dermal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53200","name":"Biopsy of urethra","description":"Biopsy of urethra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76497","name":"Unlisted ct procedure","description":"Unlisted computed tomography procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99218","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4525","name":"Adult size pull-on sm","description":"Adult sized disposable incontinence product, protective underwear/pull-on, small size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26428","name":"Repair/graft finger tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); with free graft (includes obtaining graft), each finger","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71271","name":"Ct thorax lung cancer scr c-","description":"Computed tomography, thorax, low dose for lung cancer screening, without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36246","name":"Ins cath abd/l-ext art 2nd","description":"Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53520","name":"Repair of urethra defect","description":"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2307.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63048","name":"Lam facetec &foramot ea addl","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; each additional vertebral segment, cervical, thoracic, or lumbar (list separately in addition t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42806","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, survey for unknown primary lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82654","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64865","name":"Repair of facial nerve","description":"Suture of facial nerve; infratemporal, with or without grafting","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95004","name":"Perq tests w/alrgnc xtrcs","description":"Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25924","name":"Amputation follow-up surgery","description":"Disarticulation through wrist; re-amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90826","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25394","name":"Repair carpal bone shorten","description":"Osteoplasty, carpal bone, shortening","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42870","name":"Excision of lingual tonsil","description":"Excision or destruction lingual tonsil, any method (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17272","name":"Dstr mal les s/n/h/f/g 1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67450","name":"Explore/biopsy eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); for exploration, with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0102T","name":"Esw phy anes lat hmrl epcndl","description":"Extracorporeal shock wave performed by a physician, requiring anesthesia other than local, and involving the lateral humeral epicondyle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67950","name":"Revision of eyelid","description":"Canthoplasty (reconstruction of canthus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49418","name":"Insert tun ip cath perc","description":"Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal chemotherapy instillation, management of ascites), complete procedure, including imaging guidance, catheter placement, contrast injection when performed, and radiological supervision and interpretation, percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3160","name":"Shoe styled positioning dev","description":"Foot, adjustable shoe-styled positioning device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93644","name":"Ep eval subq impl dfb","description":"Electrophysiologic evaluation of subcutaneous implantable defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11450","name":"Exc skn hdrdnt ax smpl/ntrm","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27033","name":"Arthrt hip expl/rmv loose/fb","description":"Arthrotomy, hip, including exploration or removal of loose or foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49323","name":"Laparo drain lymphocele","description":"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42961","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0356T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11011","name":"Debride skin musc at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61460","name":"Crnec sopl sctj 1+crnl nrv","description":"Craniectomy, suboccipital; for section of 1 or more cranial nerves","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36410","name":"Vnpnxr 3yr/> phy/qhp dx/ther","description":"Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88175","name":"Cytopath c/v auto fluid redo","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; with screening by automated system and manual rescreening or review, under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28234","name":"Incision of foot tendon","description":"Tenotomy, open, extensor, foot or toe, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["11004","11005","11101","11102","11103","11104","11105","11106","11109","11120","11351","11352","11354","11355","11356","11357","11358","11359","11360","11361","11362","11363","11364","11365","11366","11367","11368","11369","11370","11371","11372","11373","11374","11375","11377","11378","11379","11380","11381","11385","11386","11390","11405","11411","11412","11413","11414","11415","11416","11417","11418","11419","11420","11421","11422","11423","11424","11425","11426","11427","11428","11429","11430","11431","11432","11433","11434","11435","11436","11437","11439","11451","11499","11690","11691","11692","11693","11694","11695","11697"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69145","name":"Remove ear canal lesion(s)","description":"Excision soft tissue lesion, external auditory canal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96416","name":"Chemo prolong infuse w/pump","description":"Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36831","name":"Open thrombect av fistula","description":"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0141","name":"Scr c/v cyto,autosys and md","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75559","name":"Cardiac mri w/stress img","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material; with stress imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31647","name":"Bronchial valve init insert","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92570","name":"Acoustic immitance testing","description":"Acoustic immittance testing, includes tympanometry (impedance testing), acoustic reflex threshold testing, and acoustic reflex decay testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57558","name":"D&c of cervical stump","description":"Dilation and curettage of cervical stump","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61797","name":"Srs cran les simple addl","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional cranial lesion, simple (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58145","name":"Myomectomy vag method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; vaginal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80428","name":"Growth hormone panel","description":"Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) this panel must include the following: human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8839.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75898","name":"Follow-up angiography","description":"Angiography through existing catheter for follow-up study for transcatheter therapy, embolization or infusion, other than for thrombolysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99466","name":"Ped crit care transport","description":"Critical care face-to-face services, during an interfacility transport of critically ill or critically injured pediatric patient, 24 months of age or younger; first 30-74 minutes of hands-on care during transport","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55840","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1668.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51500","name":"Removal of bladder cyst","description":"Excision of urachal cyst or sinus, with or without umbilical hernia repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47142","name":"Partial removal donor liver","description":"Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments v, vi, vii and viii)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2800.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47531","name":"Injection for cholangiogram","description":"Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":976.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88304","name":"Tissue exam by pathologist","description":"Level iii - surgical pathology, gross and microscopic examination abortion, induced abscess aneurysm - arterial/ventricular anus, tag appendix, other than incidental artery, atheromatous plaque bartholins gland cyst bone fragment(s), other than pathologic fracture bursa/synovial cyst carpal tunnel t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97034","name":"App mdlty 1+cntrst bth ea 15","description":"Application of a modality to 1 or more areas; contrast baths, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31370","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); horizontal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67108","name":"Repair detached retina","description":"Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29450","name":"Application clubfoot cast","description":"Application of clubfoot cast with molding or manipulation, long or short leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60650","name":"Laparoscopy adrenalectomy","description":"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96415","name":"Chemo iv infusion addl hr","description":"Chemotherapy administration, intravenous infusion technique; each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70559","name":"Mri brain w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26111","name":"Exc hand les sc 1.5 cm/>","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31545","name":"Remove vc lesion w/scope","description":"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27496","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80408","name":"Aldosterone suppression eval","description":"Aldosterone suppression evaluation panel (eg, saline infusion) this panel must include the following: aldosterone (82088 x 2) renin (84244 x 2)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12053","name":"Intmd rpr face/mm 5.1-7.5 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2064","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92341","name":"Fit spectacles bifocal","description":"Fitting of spectacles, except for aphakia; bifocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35485","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50955","name":"Ureter endoscopy & biopsy","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95954","name":"Eeg monitoring/giving drugs","description":"Pharmacological or physical activation requiring physician or other qualified health care professional attendance during eeg recording of activation phase (eg, thiopental activation test)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61590","name":"Infratemporal approach/skull","description":"Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parotidectomy, craniotomy, decompression and/or mobilization of the facial nerve and/or petrous carotid a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74175","name":"Cta abdomen w/contrast","description":"Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33050","name":"Resect heart sac lesion","description":"Resection of pericardial cyst or tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81414","name":"Car ion chnnlpath inc 2 gns","description":"Cardiac ion channelopathies (eg, brugada syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); duplication/deletion gene analysis panel, must include analysis of at least 2 genes, including kcnh2 and kcnq1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88377","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73523","name":"X-ray exam hips bi 5/> views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; minimum of 5 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29305","name":"Appl hip spica cast 1 leg","description":"Application of hip spica cast; 1 leg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86834","name":"Hla class i semiquant panel","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); semi-quantitative panel (eg, titer), hla class i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81596","name":"Nfct ds chrnc hcv 6 assays","description":"Infectious disease, chronic hepatitis c virus (hcv) infection, six biochemical assays (alt, a2-macroglobulin, apolipoprotein a-1, total bilirubin, ggt, and haptoglobin) utilizing serum, prognostic algorithm reported as scores for fibrosis and necroinflammatory activity in liver","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35311","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77435","name":"Sbrt management","description":"Stereotactic body radiation therapy, treatment management, per treatment course, to 1 or more lesions, including image guidance, entire course not to exceed 5 fractions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25400","name":"Repair radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; without graft (eg, compression technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93526","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92974","name":"Cath place cardio brachytx","description":"Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44146","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99393","name":"Prev visit est age 5-11","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87210","name":"Smear wet mount saline/ink","description":"Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, india ink, koh preps)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78459","name":"Myocrd img pet single study","description":"Myocardial imaging, positron emission tomography (pet), metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), single study;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96573","name":"Pdt dstr prmlg les phys/qhp","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34111","name":"Removal of arm artery clot","description":"Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35142","name":"Repair artery rupture thigh","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, common femoral artery (profunda femoris, superficial femoral)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4189.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25607","name":"Optx dst rd xartc fx/epi sep","description":"Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"Immunization admin each add","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21048","name":"Remove maxilla cyst complex","description":"Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14020","name":"Tis trnfr s/a/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54522","name":"Orchiectomy partial","description":"Orchiectomy, partial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44008.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0181","name":"Home health care supervision","description":"Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and multidisciplinary care modalities involving regular physician or allowed practitioner development and/or revision ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94005","name":"Home vent mgmt supervision","description":"Home ventilator management care plan oversight of a patient (patient not present) in home, domiciliary or rest home (eg, assisted living) requiring review of status, review of laboratories and other studies and revision of orders and respiratory care plan (as appropriate), within a calendar month, 3","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57156","name":"Ins vag brachytx device","description":"Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58611","name":"Ligate oviduct(s) add-on","description":"Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25263","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32673","name":"Thoracoscopy w/thymus resect","description":"Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"Patient recorded spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; includes reinforced education, transmission of spirometric tracing, data capture, analysis of transmitted data, periodic recalibration and review and interpretation by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43281","name":"Lap paraesophag hern repair","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27045","name":"Exc hip/pelv tum deep 5 cm/>","description":"Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28430","name":"Cltx talus fracture w/o mnpj","description":"Closed treatment of talus fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"13133","name":"Cmplx rpr f/c/c/m/n/ax/g/h/f","description":"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2905.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91012","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4657.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6261","name":"Wound filler gel/paste /oz","description":"Wound filler, gel/paste, per fluid ounce, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82979","name":"Assay rbc glutathione","description":"Glutathione reductase, rbc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01991","name":"Anes dx/ther nrv blk&inj oth","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90862","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0890","name":"Pwc gp5 ped sing pow opt s/b","description":"Power wheelchair, group 5 pediatric, single power option, sling/solid seat/back, patient weight capacity up to and including 125 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21554","name":"Exc neck tum deep 5 cm/>","description":"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69000","name":"Drg xtrnl ear absc/hem smpl","description":"Drainage external ear, abscess or hematoma; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74240","name":"X-ray xm upr gi trc 1cntrst","description":"Radiologic examination, upper gastrointestinal tract, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3093.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50236","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through separate incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96202","name":"Mlt fam grp bhv train 1st 60","description":"Multiple-family group behavior management/modification training for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (without the patient present), face-to-face with multiple sets of paren","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11041","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27734","name":"Repair lower leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35459","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75724","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19297","name":"Place breast cath for rad","description":"Placement of radiotherapy afterloading expandable catheter (single or multichannel) into the breast for interstitial radioelement application following partial mastectomy, includes imaging guidance; concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2109.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57110","name":"Vagnc compl rmvl vag wall","description":"Vaginectomy, complete removal of vaginal wall;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94619","name":"Exercise tst brncspsm wo ecg","description":"Exercise test for bronchospasm, including pre- and post-spirometry and pulse oximetry; without electrocardiographic recording(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0283","name":"Elec stim other than wound","description":"Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20701","name":"Rmvl deep rx delivery device","description":"Removal of drug-delivery device(s), deep (eg, subfascial) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80430","name":"Growth hormone panel","description":"Growth hormone suppression panel (glucose administration) this panel must include the following: glucose (82947 x 3) human growth hormone (hgh) (83003 x 4)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81285","name":"Fxn gene charac alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58100","name":"Biopsy of uterus lining","description":"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59320","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; vaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73202","name":"Ct uppr extremity w/o&w/dye","description":"Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27500","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87591","name":"N.gonorrhoeae dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30905","name":"Control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21330","name":"Open tx nose fx w/skele fixj","description":"Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49501","name":"Rpr ing hernia init blocked","description":"Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2384.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0409","name":"Corf related serv 15 mins ea","description":"Social work and psychological services, directly relating to and/or furthering the patients rehabilitation goals, each 15 minutes, face-to-face; individual (services provided by a corf-qualified social worker or psychologist in a corf)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78801","name":"Rp loclzj tum 2+area 1+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, 2 or more areas (eg, abdomen and pelvis, head and chest), 1 or more days imaging or single area imaging over 2 or m","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6000","name":"Wound warming wound cover","description":"Non-contact wound warming wound cover for use with the non-contact wound warming device and warming card","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39502","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27680","name":"Release of lower leg tendon","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4540","name":"Reusable underpad chair size","description":"Incontinence product, protective underpad, reusable, chair size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61533","name":"Implant brain electrodes","description":"Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4483.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37215","name":"Transcath stent cca w/eps","description":"Transcatheter placement of intravascular stent(s), cervical carotid artery, open or percutaneous, including angioplasty, when performed, and radiological supervision and interpretation; with distal embolic protection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29220","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99175","name":"Induction of vomiting","description":"Ipecac or similar administration for individual emesis and continued observation until stomach adequately emptied of poison","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92353","name":"Fit aphakia spectcl multifoc","description":"Fitting of spectacle prosthesis for aphakia; multifocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87803","name":"Clostridium toxin a w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; clostridium difficile toxin a","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0430","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93231","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0246T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58140","name":"Myomectomy abdom method","description":"Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2322.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44970","name":"Laparoscopy appendectomy","description":"Laparoscopy, surgical, appendectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46922","name":"Excision of anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43305","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50782","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of duplicated ureter to bladder","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11106","name":"Incal bx skn single les","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44363","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of foreign body(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50705","name":"Ureteral embolization/occl","description":"Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KL","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01942","name":"Anes neuromd/ntrvrt lmbr/sac","description":"Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41827","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33508","name":"Endoscopic vein harvest","description":"Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22533.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87515","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01780","name":"Anes px vn upr arm&elbw nos","description":"Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64831","name":"Repair of digit nerve","description":"Suture of digital nerve, hand or foot; 1 nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21085","name":"Impres&prep oral surg splint","description":"Impression and custom preparation; oral surgical splint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26740","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48551","name":"Prep donor pancreas","description":"Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels, and y-graft arterial anastomoses from iliac artery to superio","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8265","name":"Haberman feeder","description":"Haberman feeder for cleft lip/palate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96369","name":"Sc ther infusion up to 1 hr","description":"Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); initial, up to 1 hour, including pump set-up and establishment of subcutaneous infusion site(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0378T","name":"Visual field assmnt rev/rprt","description":"Visual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"12011","name":"Rpr f/e/e/n/l/m 2.5 cm/<","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23470","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; hemiarthroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76498","name":"Unlisted mr procedure","description":"Unlisted magnetic resonance procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0603","name":"Electric breast pump","description":"Breast pump, electric (ac and/or dc), any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3201","name":"Oxford w supinat/pronat inf","description":"Orthopedic shoe, oxford with supinator or pronator, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86940","name":"Hemolysins/agglutinins auto","description":"Hemolysins and agglutinins; auto, screen, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25078","name":"Resect forarm/wrist tum 3cm>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97598","name":"Dbrdmt opn wnd addl 20cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31081","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24371","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21800","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96376","name":"Tx/pro/dx inj same drug adon","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94610","name":"Intrapulm surfactant admn","description":"Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95886","name":"Musc test done w/n test comp","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; complete, five or more muscles studied, innervated by three or more nerves or four or more spinal levels (list separately in addition to code for ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43282","name":"Lap paraesoph her rpr w/mesh","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; with implantation of mesh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43121","name":"Partial removal of esophagus","description":"Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25526","name":"Optx rdl shft fx&dstl rad/ul","description":"Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (galeazzi fracture/ dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93264","name":"Rem mntr wrls p-art prs snr","description":"Remote monitoring of a wireless pulmonary artery pressure sensor for up to 30 days, including at least weekly downloads of pulmonary artery pressure recordings, interpretation(s), trend analysis, and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81180","name":"Atxn3 gene detc abnor allele","description":"Atxn3 (ataxin 3) (eg, spinocerebellar ataxia, machado-joseph disease) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12208.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62370","name":"Anl sp inf pmp w/mdreprg&fil","description":"Electronic analysis of programmable, implanted pump for intrathecal or epidural drug infusion (includes evaluation of reservoir status, alarm status, drug prescription status); with reprogramming and refill (requiring skill of a physician or other qualified health care professional)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92242","name":"Fluorescein&icg angiography","description":"Fluorescein angiography and indocyanine-green angiography (includes multiframe imaging) performed at the same patient encounter with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64450","name":"Njx aa&/strd other pn/branch","description":"Injection(s), anesthetic agent(s) and/or steroid; other peripheral nerve or branch","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8902","name":"Mra w/o fol w/cont, abd","description":"Magnetic resonance angiography without contrast followed by with contrast, abdomen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34718","name":"Evasc rpr n/a a-iliac ndgft","description":"Endovascular repair of iliac artery, not associated with placement of an aorto-iliac artery endograft at the same session, by deployment of an iliac branched endograft, including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radi","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59100","name":"Remove uterus lesion","description":"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9262.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28322","name":"Repair of metatarsals","description":"Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95961","name":"Electrode stimulation brain","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; initial hour of attendance by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0500","name":"Mod sedat endo service >5yrs","description":"Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patients level of consciousness ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75650","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["KM","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45171","name":"Exc rect tum transanal part","description":"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26700","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49326","name":"Lap w/omentopexy add-on","description":"Laparoscopy, surgical; with omentopexy (omental tacking procedure) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33783","name":"Nikaidoh proc w/ostia implt","description":"Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, nikaidoh procedure); with reimplantation of 1 or both coronary ostia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3051.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87475","name":"Lyme dis dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); borrelia burgdorferi, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47380","name":"Open ablate liver tumor rf","description":"Ablation, open, of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25071","name":"Exc forearm les sc 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93296","name":"Rem interrog evl pm/ids","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15771","name":"Grfg autol fat lipo 50 cc/<","description":"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26113","name":"Exc hand tum deep 1.5 cm/>","description":"Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34520","name":"Cross-over vein graft","description":"Cross-over vein graft to venous system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75564","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99219","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27760","name":"Cltx medial ankle fx","description":"Closed treatment of medial malleolus fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69400","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97167","name":"Ot eval high complex 60 min","description":"Occupational therapy evaluation, high complexity, requiring these components: an occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20822","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"Init pm e/m new pat infant","description":"Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age youn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61313","name":"Crnec/crnot sttl icere","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78122","name":"Whl bld volume determination","description":"Whole blood volume determination, including separate measurement of plasma volume and red cell volume (radiopharmaceutical volume-dilution technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85245","name":"Clot factor viii vw ristoctn","description":"Clotting; factor viii, vw factor, ristocetin cofactor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33951","name":"Ecmo/ecls insj prph cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49657","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77412","name":"Radiation tx delivery lvl 3","description":"Radiation treatment delivery; level 3, multiple isocenters with photon therapy (eg, 2d, 3d, or imrt) or a single-isocenter photon therapy (eg, 3d or imrt) with active motion management, or total skin electrons, or mixed-electron/photon field(s), including imaging guidance, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["GN","95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88369","name":"M/phmtrc alysishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), manual, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1225","name":"Manual semi-reclining back","description":"Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93270","name":"Remote 30 day ecg rev/report","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; recording (includes connection, recording, and disconnection)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69645","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92981","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76816","name":"Ob us follow-up per fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, re-evaluation of fetal size by measuring standard growth parameters and amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed to be abnormal on a previous scan), transabdominal approach, per fetu","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"60505","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2330.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33286","name":"Rmvl subq car rhythm mntr","description":"Removal, subcutaneous cardiac rhythm monitor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85390","name":"Fibrinolysins screen i&r","description":"Fibrinolysins or coagulopathy screen, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5797.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3493.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93284","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous impla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32602","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S2083","name":"Adjustment gastric band","description":"Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22810","name":"Arthrd ant dfrm 4-7 vrt sgm","description":"Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0071","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96571","name":"Photodynamic tx addl 15 min","description":"Photodynamic therapy by endoscopic application of light to ablate abnormal tissue via activation of photosensitive drug(s); each additional 15 minutes (list separately in addition to code for endoscopy or bronchoscopy procedures of lung and gastrointestinal tract)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21454","name":"Optx mndblr fx xtrnl fixj","description":"Open treatment of mandibular fracture with external fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46937","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65820","name":"Goniotomy","description":"Goniotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23665","name":"Cltx sho dslc fx gr hmrl tbr","description":"Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67025","name":"Replace eye fluid","description":"Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64489","name":"Tap block bi by infusion","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) bilateral; by continuous infusions (includes imaging guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93297","name":"Rem interrog dev eval icpms","description":"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other quali","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27750","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1892.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84403","name":"Assay of total testosterone","description":"Testosterone; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96922","name":"Excimer lsr psriasis>500sqcm","description":"Excimer laser treatment for psoriasis; over 500 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99360","name":"Physician standby services","description":"Standby service, requiring prolonged attendance, each 30 minutes (eg, operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring eeg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2198.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1853.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C2617","name":"Stent, non-cor, tem w/o del","description":"Stent, non-coronary, temporary, without delivery system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52234","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; small bladder tumor(s) (0.5 up to 2.0 cm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33411","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92653","name":"Aep neurodiagnostic i&r","description":"Auditory evoked potentials; neurodiagnostic, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9500","name":"Tc99m sestamibi","description":"Technetium tc-99m sestamibi, diagnostic, per study dose","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29058","name":"Appl cast plaster velpeau","description":"Application, cast; plaster velpeau","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58553","name":"Laparo-vag hyst complex","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27027","name":"Dcmprn fasct pel compartment","description":"Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle), unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99493","name":"Sbsq psyc collab care mgmt","description":"Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional, with the following required el","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70482","name":"Ct orbit/ear/fossa w/o&w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1626.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77520","name":"Proton trmt simple w/o comp","description":"Proton treatment delivery; simple, without compensation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6005","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0879","name":"Pwc gp4 hd sing pow opt s/b","description":"Power wheelchair, group 4 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01234","name":"Anes opn upr 2/3 fem rad res","description":"Anesthesia for open procedures involving upper two-thirds of femur; radical resection","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96423","name":"Chemo ia infuse each addl hr","description":"Chemotherapy administration, intra-arterial; infusion technique, each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64617","name":"Chemodener muscle larynx emg","description":"Chemodenervation of muscle(s); larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0306","name":"Cbc/diffwbc w/o platelet","description":"Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and automated wbc differential count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95147","name":"Antigen therapy services","description":"Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy (specify number of doses); 3 single stinging insect venoms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67924","name":"Repair eyelid defect","description":"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21550","name":"Biopsy of neck/chest","description":"Biopsy, soft tissue of neck or thorax","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61795","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36147","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29902","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, stener lesion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49451","name":"Replace duod/jej tube perc","description":"Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42508","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83925","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33945","name":"Transplantation of heart","description":"Heart transplant, with or without recipient cardiectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6784.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78483","name":"Heart first pass multiple","description":"Cardiac blood pool imaging (planar), first pass technique; multiple studies, at rest and with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0445","name":"High inten beh couns std 30m","description":"High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77300","name":"Radiation therapy dose plan","description":"Basic radiation dosimetry calculation, central axis depth dose calculation, tdf, nsd, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of non-ionizing radiation surface and depth dose, as required during course of treatment, only when prescribed by the treating physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88385","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22818","name":"Kyphectomy 1-2 segments","description":"Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87580","name":"M.pneumon dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2055.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50840","name":"Replace ureter by bowel","description":"Replacement of all or part of ureter by intestine segment, including intestine anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0413","name":"Pelvic ring fracture uni/bil","description":"Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, (includes ilium, sacroiliac joint and/or sacrum)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50205","name":"Renal bx surg exposure kdn","description":"Renal biopsy; by surgical exposure of kidney","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67414","name":"Explr/decompress eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61559","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4266","name":"Diaphragm","description":"Diaphragm for contraceptive use","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45915","name":"Remove rectal obstruction","description":"Removal of fecal impaction or foreign body (separate procedure) under anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3751.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11301","name":"Shave skin lesion 0.6-1.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.6 to 1.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81165","name":"Brca1 gene full seq alys","description":"Brca1 (brca1, dna repair associated) (eg, hereditary breast and ovarian cancer) gene analysis; full sequence analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90467","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11055","name":"Paring/cutg b9 hyprker les 1","description":"Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5241","name":"Dispensing fee, monaural","description":"Dispensing fee, monaural hearing aid, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87071","name":"Culture aerobic quant other","description":"Culture, bacterial; quantitative, aerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0429","name":"Dermal filler injection(s)","description":"Dermal filler injection(s) for the treatment of facial lipodystrophy syndrome (lds) (e.g., as a result of highly active antiretroviral therapy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58951","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27232","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56420","name":"I&d bartholins gland abscess","description":"Incision and drainage of bartholins gland abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01832","name":"Anes arthr/ndsc tot wrst rpl","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; total wrist replacement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62267","name":"Interdiscal perq aspir dx","description":"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0330T","name":"Tear film img uni/bi w/i&r","description":"Tear film imaging, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47480","name":"Incision of gallbladder","description":"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66179","name":"Aqueous shunt eye w/o graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11951","name":"Subq njx fil matrl 1.1-5.0cc","description":"Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57425","name":"Laparoscopy surg colpopexy","description":"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01939","name":"Anes nulyt agt crv/thrc","description":"Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31636","name":"Bronchoscopy bronch stents","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of bronchial stent(s) (includes tracheal/bronchial dilation as required), initial bronchus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5475.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3179.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78494","name":"Heart image spect","description":"Cardiac blood pool imaging, gated equilibrium, spect, at rest, wall motion study plus ejection fraction, with or without quantitative processing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90947","name":"Dialysis repeated eval","description":"Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies) requiring repeated evaluations by a physician or other qualified health care professional, with or without substantial revision of dialysis prescription","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99223","name":"1st hosp ip/obs high 75","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8421","name":"Ready gradient sleev/glov","description":"Gradient pressure aid (sleeve and glove combination), ready made","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25040","name":"Arthrt rdcrpl/midcarpl jt","description":"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69633","name":"Rebuild eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (eg, partial ossicular replacement prosthesis [porp], total ossicular replacement prosthesis [torp])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21141","name":"Rcnstj midface lefort i 1pc","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction (eg, for long face syndrome), without bone graft","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69511","name":"Extensive mastoid surgery","description":"Mastoidectomy; radical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43101","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47350","name":"Repair liver wound","description":"Management of liver hemorrhage; simple suture of liver wound or injury","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99148","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27455","name":"Realignment of knee","description":"Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); before epiphyseal closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29345","name":"Application of long leg cast","description":"Application of long leg cast (thigh to toes);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19281","name":"Perq device breast 1st imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93299","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32673","name":"Thoracoscopy w/thymus resect","description":"Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25215","name":"Removal of wrist bones","description":"Carpectomy; all bones of proximal row","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99479","name":"Sbsq ic lbw inf 1,500-2,500","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering low birth weight infant (present body weight of 1,500-2,500 grams)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00810","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62326","name":"Njx interlaminar lmbr/sac","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1853.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23490","name":"Reinforce clavicle","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86830","name":"Hla class i phenotype qual","description":"Antibody to human leukocyte antigens (hla), solid phase assays (eg, microspheres or beads, elisa, flow cytometry); antibody identification by qualitative panel using complete hla phenotypes, hla class i","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45300","name":"Proctosigmoidoscopy dx","description":"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44715","name":"Prepare donor intestine","description":"Backbench standard preparation of cadaver or living donor intestine allograft prior to transplantation, including mobilization and fashioning of the superior mesenteric artery and vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64479","name":"Njx aa&/strd tfrm epi c/t 1","description":"Injection(s), anesthetic agent(s) and/or steroid; transforaminal epidural, with imaging guidance (fluoroscopy or ct), cervical or thoracic, single level","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27488","name":"Removal of knee prosthesis","description":"Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70496","name":"Ct angiography head","description":"Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73720","name":"Mri lwr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50386","name":"Remove stent via transureth","description":"Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33403","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1638.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32603","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44227","name":"Lap close enterostomy","description":"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50325","name":"Prep donor renal graft","description":"Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32561","name":"Lyse chest fibrin init day","description":"Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic agent for break up of multiloculated effusion); initial day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42510","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with ligation of both submandibular (whartons) ducts","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31290","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2590.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25670","name":"Optx rdcrpl/ntrcrpl dislc 1+","description":"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80069","name":"Renal function panel","description":"Renal function panel this panel must include the following: albumin (82040) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphorus inorganic (phosphate) (84100) potassium (84132) sodium (84295) urea nitrogen (bun) (84520)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49496","name":"Rpr ing hernia baby blocked","description":"Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; incarcerated or strangulated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36575","name":"Repair tunneled cv cath","description":"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99487","name":"Cplx chrnc care 1st 60 min","description":"Complex chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92992","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26340","name":"Manipulate finger w/anesth","description":"Manipulation, finger joint, under anesthesia, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43305","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2292","name":"Planar seat for ped size wc","description":"Seat, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87538","name":"Hiv-2 probe&revrse trnscripj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-2, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15151.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29710","name":"Rmvl/bivlv sho/hip spica","description":"Removal or bivalving; shoulder or hip spica, minerva, or risser jacket, etc.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94720","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21145","name":"Rcnstj mdfc lefort i 1 w/grf","description":"Reconstruction midface, lefort i; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2549.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2534.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93976","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87350","name":"Hepatitis be ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; hepatitis be antigen (hbeag)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0441T","name":"Abltj perc lxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86826","name":"Hla x-match noncytotoxc addl","description":"Human leukocyte antigen (hla) crossmatch, non-cytotoxic (eg, using flow cytometry); each additional serum sample or sample dilution (list separately in addition to primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6240.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27339","name":"Exc thigh/knee tum dep 5cm/>","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96446","name":"Chemotx admn pertl cav impl","description":"Chemotherapy administration into the peritoneal cavity via implanted port or catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96119","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42140","name":"Excision of uvula","description":"Uvulectomy, excision of uvula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50825","name":"Construct bowel bladder","description":"Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (kock pouch or camey enterocystoplasty)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S2083","name":"Adjustment gastric band","description":"Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97605","name":"Neg prs wnd ther dme<=50sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area less than or equal to 50 square centimeters","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58970","name":"Retrieval of oocyte","description":"Follicle puncture for oocyte retrieval, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1760","name":"Closure dev, vasc","description":"Closure device, vascular (implantable/insertable)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"38204","name":"Bl donor search management","description":"Management of recipient hematopoietic progenitor cell donor search and cell acquisition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62328","name":"Dx lmbr spi pnxr w/fluor/ct","description":"Spinal puncture, lumbar, diagnostic; with fluoroscopic or ct guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1668.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87561","name":"M.avium-intra dna amp prob","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, amplified probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92588","name":"Evoked auditory tst complete","description":"Distortion product evoked otoacoustic emissions; comprehensive diagnostic evaluation (quantitative analysis of outer hair cell function by cochlear mapping, minimum of 12 frequencies), with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50360","name":"Rnl altrnsplj w/o rcp nfrct","description":"Renal allotransplantation, implantation of graft; without recipient nephrectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27047","name":"Exc hip/pelvis les sc < 3 cm","description":"Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4099","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69150","name":"Extensive ear canal surgery","description":"Radical excision external auditory canal lesion; without neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73723","name":"Mri joint lwr extr w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63704","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; less than 5 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61332","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49421","name":"Ins tun ip cath for dial opn","description":"Insertion of tunneled intraperitoneal catheter for dialysis, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3257.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66983","name":"Cataract surg w/iol 1 stage","description":"Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97598","name":"Dbrdmt opn wnd addl 20cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44211","name":"Lap colectomy w/proctectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (s or j), with loop ileostomy, includes rectal mucosectomy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27652","name":"Repair/graft achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon; with graft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41007","name":"Drainage of mouth lesion","description":"Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01400","name":"Anes opn/arthrs knee jt nos","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B5000","name":"Parenteral sol renal-amirosy","description":"Parenteral nutrition solution compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, renal-aminosyn-rf, nephramine, renamine-premix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"61539","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64613","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69990","name":"Microsurgery add-on","description":"Microsurgical techniques, requiring use of operating microscope (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87070","name":"Culture othr specimn aerobic","description":"Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"99190","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); each hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85097","name":"Bone marrow interpretation","description":"Bone marrow, smear interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25150","name":"Partial removal of ulna","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43310","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62284","name":"Injection for myelogram","description":"Injection procedure for myelography and/or computed tomography, lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99050","name":"Medical services after hrs","description":"Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (eg, holidays, saturday or sunday), in addition to basic service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61105","name":"Tdh sdrl/ventr pnxr","description":"Twist drill hole for subdural or ventricular puncture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3952.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78831","name":"Rp loclzj tum spect 2 areas","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), minimum 2 areas (eg, pelvis and knees, chest and abdomen) or separate acquisitions (eg, lung ventilati","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62311","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8911","name":"Mra w/o fol w/cont, chest","description":"Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20922","name":"Removal of fascia for graft","description":"Fascia lata graft; by incision and area exposure, complex or sheet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82696","name":"Assay of etiocholanolone","description":"Etiocholanolone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"81422","name":"Fetal chrmoml microdeltj","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, digeorge syndrome, cri-du-chat syndrome), circulating cell-free fetal dna in maternal blood","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92014","name":"Compre oph exam est pt 1/>","description":"Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97550","name":"Caregiver traing 1st 30 min","description":"Caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the patie","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57268","name":"Repair of bowel bulge","description":"Repair of enterocele, vaginal approach (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00604","name":"Anes px crv spn&cord sitting","description":"Anesthesia for procedures on cervical spine and cord; procedures with patient in the sitting position","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77085","name":"Dxa bone density axl vrt fx","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25929","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; secondary closure or scar revision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3103.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0516T","name":"Insj wcs lv eltrd only","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; electrode only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11302","name":"Shave skin lesion 1.1-2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0323","name":"Care manage beh svs 20mins","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical psychologist, clinical social worker, mental health counselor, or marriage and family therapist time, per calendar month. (these services include the following required elements: initial assessment or follow-u","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29877","name":"Arthrs knee surg dbrdmt/shvg","description":"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["AU","AV"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29325","name":"Appl hip spica cast1&1/2","description":"Application of hip spica cast; 1 and one-half spica or both legs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01937","name":"Anes drg/aspir crv/thrc","description":"Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69660","name":"Revise middle ear bone","description":"Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88269","name":"Chromosome analys amniotic","description":"Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 colonies, 1 karyotype, with banding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92616","name":"Fees w/laryngeal sense test","description":"Flexible endoscopic evaluation of swallowing and laryngeal sensory testing by cine or video recording;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27006","name":"Tenotomy abductor&/xtnsr hip","description":"Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2213","name":"Initiat med assist tx in er","description":"Initiation of medication for the treatment of opioid use disorder in the emergency department setting, including assessment, referral to ongoing care, and arranging access to supportive services (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63182","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86788","name":"West nile virus ab igm","description":"Antibody; west nile virus, igm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23000","name":"Rmvl sbdltd clcreous dep opn","description":"Removal of subdeltoid calcareous deposits, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73722","name":"Mri joint of lwr extr w/dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8339.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11308","name":"Shave skin lesion >2.0 cm","description":"Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61698","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25905","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna; open, circular (guillotine)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57240","name":"Anterior colporrhaphy","description":"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45805","name":"Repair fistula w/colostomy","description":"Closure of rectovesical fistula; with colostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10004","name":"Fna bx w/o img gdn ea addl","description":"Fine needle aspiration biopsy, without imaging guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6218","name":"Non-sterile gauze > 48 sq in","description":"Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42200","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, soft and/or hard palate only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00120","name":"Anes px ear w/bx nos","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95719","name":"Eeg phys/qhp ea incr w/o vid","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, each increment of greater than 12 hours, up to 26 hours of eeg recording, interpretation and report after each 24-hour period; w","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00836","name":"Anes hrna rpr<37wk brth<50","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83993","name":"Assay for calprotectin fecal","description":"Calprotectin, fecal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9502","name":"Tc99m tetrofosmin","description":"Technetium tc-99m tetrofosmin, diagnostic, per study dose","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24200","name":"Rmvl fb upper arm/elbw subq","description":"Removal of foreign body, upper arm or elbow area; subcutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28531","name":"Treat sesamoid bone fracture","description":"Open treatment of sesamoid fracture, with or without internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82541","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2848.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"94012","name":"Spirmtry w/brnchdil inf-2 yr","description":"Measurement of spirometric forced expiratory flows, before and after bronchodilator, in an infant or child through 2 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71551","name":"Mri chest w/dye","description":"Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and mediastinal lymphadenopathy); with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30620","name":"Intranasal reconstruction","description":"Septal or other intranasal dermatoplasty (does not include obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1236.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2507.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4670","name":"Automatic bp monitor, dial","description":"Automatic blood pressure monitor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2106.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4855.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19369","name":"Brst rcnstj 2 pdcl tram flap","description":"Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26500","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33870","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75790","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88375","name":"Optical endomicroscpy interp","description":"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33284","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28280","name":"Fusion of toes","description":"Syndactylization, toes (eg, webbing or kelikian type procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78808","name":"Iv inj ra drug dx study","description":"Injection procedure for radiopharmaceutical localization by non-imaging probe study, intravenous (eg, parathyroid adenoma)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42961","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44210","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64752","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"T4529","name":"Ped size brief/diaper sm/med","description":"Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82492","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31632","name":"Bronchoscopy/lung bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72148","name":"Mri lumbar spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35470","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45108","name":"Anorectal myomectomy","description":"Anorectal myomectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3799.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78072","name":"Parathyrd planar w/spect&ct","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect), and concurrently acquired computed tomography (ct) for anatomical localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87283","name":"Rubeola ag if","description":"Infectious agent antigen detection by immunofluorescent technique; rubeola","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25905","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna; open, circular (guillotine)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90970","name":"Esrd svc pr day pt 20+","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients 20 years of age and older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["GT","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85302","name":"Clot inhibit prot c antigen","description":"Clotting inhibitors or anticoagulants; protein c, antigen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11922","name":"Correct skin color ea 20.0cm","description":"Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0514","name":"Prolong prev svcs, addl 30m","description":"Prolonged preventive service(s) (beyond the typical service time of the primary procedure), in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (list separately in addition to code g0513 for additional 30 minutes of preventi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28240","name":"Release of big toe","description":"Tenotomy, lengthening, or release, abductor hallucis muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27269","name":"Optx thigh fx","description":"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33285","name":"Insj subq car rhythm mntr","description":"Insertion, subcutaneous cardiac rhythm monitor, including programming","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92517","name":"Vemp test i&r cervical","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50230","name":"Removal kidney open radical","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29010","name":"Appl risser jacket body only","description":"Application of risser jacket, localizer, body; only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5339.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36573","name":"Insj picc rs&i 5 yr+","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; age 5 years or older","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70540","name":"Mri orbit/face/neck w/o dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10008","name":"Fna bx w/fluor gdn ea addl","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; each additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78433","name":"Myocrd img pet 2rtracer ct","description":"Myocardial imaging, positron emission tomography (pet), combined perfusion with metabolic evaluation study (including ventricular wall motion[s] and/or ejection fraction[s], when performed), dual radiotracer (eg, myocardial viability); with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31541","name":"Larynscop w/tumr exc + scope","description":"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80439","name":"Trh stimulation panel","description":"Thyrotropin releasing hormone (trh) stimulation panel; 2 hour this panel must include the following: thyroid stimulating hormone (tsh) (84443 x 4)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64451","name":"Njx aa&/strd nrv nrvtg si jt","description":"Injection(s), anesthetic agent(s) and/or steroid; nerves innervating the sacroiliac joint, with image guidance (ie, fluoroscopy or computed tomography)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24655","name":"Cltx rdl head/nck fx w/mnpj","description":"Closed treatment of radial head or neck fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15297.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3132.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43116","name":"Partial removal of esophagus","description":"Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, obtaining the graft and intestinal reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2472.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93464","name":"Exercise w/hemodynamic meas","description":"Physiologic exercise study (eg, bicycle or arm ergometry) including assessing hemodynamic measurements before and after (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32486","name":"Sleeve lobectomy","description":"Removal of lung, other than pneumonectomy; with circumferential resection of segment of bronchus followed by broncho-bronchial anastomosis (sleeve lobectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15365","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93229","name":"Remote 30 day ecg tech supp","description":"External mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ecg data storage (retrievable with query) with ecg triggered and patient selected events transmitted to a remote attended surveillance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4267","name":"Male condom","description":"Contraceptive supply, condom, male, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01925","name":"Anes ivntl rad artl crtd/c","description":"Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93231","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95027","name":"Iq tsts seql&incrl airborne","description":"Intracutaneous (intradermal) tests, sequential and incremental, with allergenic extracts for airborne allergens, immediate type reaction, including test interpretation and report, specify number of tests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"C9113","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","AU","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87491","name":"Chlmyd trach dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, amplified probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95977","name":"Alys cplx cn npgt prgrmg","description":"Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop pa","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63180","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0308T","name":"Insj ocular telescope prosth","description":"Insertion of ocular telescope prosthesis including removal of crystalline lens or intraocular lens prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80422","name":"Glucagon tolerance panel","description":"Glucagon tolerance panel; for insulinoma this panel must include the following: glucose (82947 x 3) insulin (83525 x 3)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69990","name":"Microsurgery add-on","description":"Microsurgical techniques, requiring use of operating microscope (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90875","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 30 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31623","name":"Dx bronchoscope/brush","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93542","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36593","name":"Declot vascular device","description":"Declotting by thrombolytic agent of implanted vascular access device or catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63302","name":"Remove vert xdrl body thrlmb","description":"Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6007","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26483","name":"Transplant/graft hand tendon","description":"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with free tendon graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44050","name":"Reduce bowel obstruction","description":"Reduction of volvulus, intussusception, internal hernia, by laparotomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26861","name":"Fusion of finger jnt add-on","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13120","name":"Cmplx rpr s/a/l 1.1-2.5 cm","description":"Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93283","name":"Prgrmg eval implantable dfb","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantab","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31367","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, without radical neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1642.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46200","name":"Removal of anal fissure","description":"Fissurectomy, including sphincterotomy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53431","name":"Reconstruct urethra/bladder","description":"Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, tenago, leadbetter procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36575","name":"Repair tunneled cv cath","description":"Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0400","name":"Home sleep test/type 4 porta","description":"Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61510","name":"Crnec treph exc brn tum sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2004.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76881","name":"Us compl joint r-t w/img","description":"Ultrasound, complete joint (ie, joint space and peri-articular soft-tissue structures), real-time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33474","name":"Revision of pulmonary valve","description":"Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1894.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2337.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11107","name":"Incal bx skn ea sep/addl","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separate/additional lesion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9516","name":"Iodine i-123 sod iodide mic","description":"Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91010","name":"Esophagus motility study","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58760","name":"Fimbrioplasty","description":"Fimbrioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11046","name":"Dbrdmt musc&/fsca ea addl","description":"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66185","name":"Revise aqueous shunt eye","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93975","name":"Vascular study","description":"Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49460","name":"Fix g/colon tube w/device","description":"Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including contrast injection(s), if performed, image documentation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81174","name":"Ar gene known famil variant","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; known familial variant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49525","name":"Repair ing hernia sliding","description":"Repair inguinal hernia, sliding, any age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40700","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34451","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by abdominal and leg incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22851","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44620","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29850","name":"Knee arthroscopy/surgery","description":"Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46900","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21010","name":"Incision of jaw joint","description":"Arthrotomy, temporomandibular joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7261","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61700","name":"Brain aneurysm repr simple","description":"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33891","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90956","name":"Esrd srv 1 visit p mo 2-11","description":"End-stage renal disease (esrd) related services monthly, for patients 2-11 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per month","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86709","name":"Hepatitis a igm antibody","description":"Hepatitis a antibody (haab), igm antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29044","name":"Appl bdy cst sho to hip 1thi","description":"Application of body cast, shoulder to hips; including 1 thigh","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49570","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43283","name":"Lap esoph lengthening","description":"Laparoscopy, surgical, esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93986","name":"Dup-scan hemo compl uni std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete unilateral study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27358","name":"Remove femur lesion/fixation","description":"Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (list in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3485","name":"Shoe heel pad removable for","description":"Heel, pad, removable for spur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11770","name":"Exc pilonidal cyst simple","description":"Excision of pilonidal cyst or sinus; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9645.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0498T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00622","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27509","name":"Treatment of thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or without intercondylar extension, or distal femoral epiphyseal separation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48120","name":"Removal of pancreas lesion","description":"Excision of lesion of pancreas (eg, cyst, adenoma)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50740","name":"Fusion of ureter & kidney","description":"Ureteropyelostomy, anastomosis of ureter and renal pelvis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93540","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77067","name":"Scr mammo bi incl cad","description":"Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27200","name":"Treat tail bone fracture","description":"Closed treatment of coccygeal fracture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75902","name":"Remove cva lumen obstruct","description":"Mechanical removal of intraluminal (intracatheter) obstructive material from central venous device through device lumen, radiologic supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0316","name":"Prolong inpt eval add15 m","description":"Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35211","name":"Rpr blvsl dir ntrathrc w/byp","description":"Repair blood vessel, direct; intrathoracic, with bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33967","name":"Insert i-aort percut device","description":"Insertion of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69711","name":"Remove/repair hearing aid","description":"Removal or repair of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87531","name":"Hhv-6 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0452","name":"Molecular pathology interpr","description":"Molecular pathology procedure; physician interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28302","name":"Incision of ankle bone","description":"Osteotomy; talus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77772","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46280","name":"Remove anal fist complex","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48540","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; roux-en-y","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83789","name":"Mass spectrometry qual/quan","description":"Mass spectrometry and tandem mass spectrometry (eg, ms, ms/ms, maldi, ms-tof, qtof), non-drug analyte(s) not elsewhere specified, qualitative or quantitative, each specimen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42409","name":"Drainage of salivary cyst","description":"Marsupialization of sublingual salivary cyst (ranula)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85335","name":"Factor inhibitor test","description":"Factor inhibitor test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0558","name":"Adv prim care mgmt lvl 3","description":"Advanced primary care management services for a patient that is a qualified medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk of death, acute exacerbation/decompensat","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95811","name":"Polysom 6/>yrs cpap 4/> parm","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bilevel ventilation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29044","name":"Appl bdy cst sho to hip 1thi","description":"Application of body cast, shoulder to hips; including 1 thigh","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99483","name":"Assmt & care pln pt cog imp","description":"Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home, with all of the following required elements: cognition-focused evaluation including a pertinent history and examination, m","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1835.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77002","name":"Needle localization by xray","description":"Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, localization device) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33988","name":"Insertion of left heart vent","description":"Insertion of left heart vent by thoracic incision (eg, sternotomy, thoracotomy) for ecmo/ecls","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31627","name":"Navigational bronchoscopy","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (list separately in addition to code for primary procedure[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1869.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61314","name":"Crnec/crnot ittl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10509","10512","10516","10524","10537","10541","10542","10579","10910","10912","10914","10915","10916","10917","10918","10919","10921","10922","10924","10925","10926","10928","10930","10932","10933","10940","10941","10943","10949","10950","10953","10958","10959","10963","10969","10973","10975","10979","10981","10985","10987","10988","10990","10992","10996","10997","10998","12015","12017","12029","12037","12042","12050","12051","12058","12060","12075","12083","12087","12106","12115","12124","12125","12130","12132","12136","12165","12167","12172","12173","12174","12176","12184","12192","12195","12401","12402","12404","12405","12406","12407","12409","12410","12411","12412","12413","12414","12416","12417","12418","12419","12420","12421","12422","12423","12424","12427","12428","12429","12430","12431","12432","12433","12434","12435","12436","12438","12439","12440","12441","12442","12443","12444","12446","12448","12449","12450","12451","12452","12453","12454","12455","12456","12457","12458","12459","12460","12461","12463","12464","12465","12466","12468","12470","12471","12472","12473","12474","12475","12477","12480","12481","12482","12483","12484","12485","12486","12487","12489","12490","12491","12492","12493","12494","12495","12496","12498","12501","12502","12503","12504","12506","12507","12508","12510","12511","12512","12513","12514","12515","12516","12517","12518","12520","12521","12522","12523","12524","12525","12526","12527","12528","12529","12530","12531","12533","12534","12537","12538","12540","12541","12542","12543","12544","12545","12546","12547","12548","12549","12550","12551","12552","12553","12555","12561","12563","12564","12565","12566","12567","12568","12569","12570","12571","12572","12574","12575","12577","12578","12580","12581","12582","12583","12584","12585","12586","12588","12589","12590","12592","12593","12594","12601","12602","12603","12604","12701","12719","12720","12721","12722","12723","12724","12725","12726","12727","12729","12732","12733","12734","12736","12737","12738","12740","12741","12742","12743","12745","12746","12747","12748","12749","12750","12751","12752","12754","12758","12759","12760","12762","12763","12764","12765","12766","12767","12768","12769","12770","12771","12775","12776","12777","12778","12779","12780","12781","12782","12783","12784","12785","12786","12787","12788","12789","12790","12791","12792","13731","13739","13740","13750","13751","13752","13753","13755","13756","13757","13774","13775","13782","13783","13786","13788","13804","13806","13837","13838","13839","13842","13846","13847","13856","13860"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27634","name":"Exc leg/ankle tum dep 5 cm/>","description":"Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75901","name":"Remove cva device obstruct","description":"Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from central venous device via separate venous access, radiologic supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0222T","name":"Plmt post facet implt addl","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81514","name":"Nfct ds bv&vaginitis dna alg","description":"Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of dna markers for gardnerella vaginalis, atopobium vaginae, megasphaera type 1, bacterial vaginosis associated bacteria-2 (bvab-2), and lactobacillus species (l. crispatus and l. jensenii), utilizing vaginal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93288","name":"Interrog evl pm/ldls pm ip","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead pacemaker system, or leadless pacemaker system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51595","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"Demo&/eval pt use inhaler","description":"Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or ippb device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29530","name":"Strapping of knee","description":"Strapping; knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37500","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0880","name":"Pwc gp4 vhd sing pow opt s/b","description":"Power wheelchair, group 4 very heavy duty, single power option, sling/solid seat/back, patient weight 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3960.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45160","name":"Excision of rectal lesion","description":"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84270","name":"Assay of sex hormone globul","description":"Sex hormone binding globulin (shbg)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3842.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4651","name":"Calibrated microcap tube","description":"Calibrated microcapillary tube, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69145","name":"Remove ear canal lesion(s)","description":"Excision soft tissue lesion, external auditory canal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22800","name":"Arthrd pst dfrm<6 vrt sgm","description":"Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2009","name":"Post-d/c h vst ext pt 60 m","description":"Comprehensive (60 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatien","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4765","name":"Dialysate conc pow per pack","description":"Dialysate concentrate, powder, additive for peritoneal dialysis, per packet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27267","name":"Cltx thigh fx","description":"Closed treatment of femoral fracture, proximal end, head; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00670","name":"Anes xtnsv sp&spi cord px","description":"Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21175","name":"Rcnst bfrnt sp orb rm&lw fhd","description":"Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99232","name":"Sbsq hosp ip/obs moderate 35","description":"Subsequent hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 35 minut","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10488.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26542","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"Esrd srv 4 visits p mo 20+","description":"End-stage renal disease (esrd) related services monthly, for patients 20 years of age and older; with 4 or more face-to-face visits by a physician or other qualified health care professional per month","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62305","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, lumbar/cervical, lumbar/thoracic/cervical)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00938","name":"Anes insj penile prosthesis","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93292","name":"Wcd device interrogate","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; wearable defibrillator system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92978","name":"Endoluminl ivus oct c 1st","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (list separately in addition to code for p","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67345","name":"Destroy nerve of eye muscle","description":"Chemodenervation of extraocular muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22905","name":"Rad resect abd tumor 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; 5 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26740","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51797","name":"Intraabdominal pressure test","description":"Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27070","name":"Part remove hip bone super","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86294","name":"Immunoassay tumor qual","description":"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99494","name":"1st/sbsq psyc collab care","description":"Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified health care professional (list separa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50980","name":"Ureter endoscopy & treatment","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46942","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42892","name":"Revision of pharyngeal walls","description":"Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25490","name":"Prophylactic tx radius","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78481","name":"Heart first pass single","description":"Cardiac blood pool imaging (planar), first pass technique; single study, at rest or with stress (exercise and/or pharmacologic), wall motion study plus ejection fraction, with or without quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99150","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"Evoked auditory test limited","description":"Distortion product evoked otoacoustic emissions; limited evaluation (to confirm the presence or absence of hearing disorder, 3-6 frequencies) or transient evoked otoacoustic emissions, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22633","name":"Arthrd cmbn 1ntrspc lumbar","description":"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28299","name":"Cor hlx vlgs double osteot","description":"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69602","name":"Rev mstdc rslt mod rad mstdc","description":"Revision mastoidectomy; resulting in modified radical mastoidectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93657","name":"Tx l/r atrial fib addl","description":"Additional linear or focal intracardiac catheter ablation of the left or right atrium for treatment of atrial fibrillation remaining after completion of pulmonary vein isolation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90876","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 45 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95714","name":"Veeg ea 12-26 hr unmntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, each increment of 12-26 hours; unmonitored","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54680","name":"Relocation of testis(es)","description":"Transplantation of testis(es) to thigh (because of scrotal destruction)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0168","name":"Wound closure by adhesive","description":"Wound closure utilizing tissue adhesive(s) only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84152","name":"Assay of psa complexed","description":"Prostate specific antigen (psa); complexed (direct measurement)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83898","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0322","name":"Home h physio data collec tr","description":"The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80196","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59850","name":"Induced abortion 1+ njx","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35523","name":"Art byp grft brchl-ulnr-rdl","description":"Bypass graft, with vein; brachial-ulnar or -radial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14061","name":"Tis trnfr e/n/e/l10.1-30sqcm","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30140","name":"Resect inferior turbinate","description":"Submucous resection inferior turbinate, partial or complete, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59525","name":"Remove uterus after cesarean","description":"Subtotal or total hysterectomy after cesarean delivery (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0115","name":"Post-coital mucous exam","description":"Post-coital direct, qualitative examinations of vaginal or cervical mucous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27888","name":"Amputation of foot at ankle","description":"Amputation, ankle, through malleoli of tibia and fibula (eg, syme, pirogoff type procedures), with plastic closure and resection of nerves","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43251","name":"Egd remove lesion snare","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74210","name":"X-ray xm phrnx&/crv esoph c+","description":"Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s), when performed, contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46060","name":"I&d ischiorectal/ntrmrl absc","description":"Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54800","name":"Biopsy of epididymis","description":"Biopsy of epididymis, needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31571","name":"Laryngoscop w/vc inj + scope","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82103","name":"Alpha-1-antitrypsin total","description":"Alpha-1-antitrypsin; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0239","name":"Oth resp proc, group","description":"Therapeutic procedures to improve respiratory function or increase strength or endurance of respiratory muscles, two or more individuals (includes monitoring)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36555","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35694","name":"Art trnsposj subclav carotid","description":"Transposition and/or reimplantation; subclavian to carotid artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90821","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26735","name":"Treat finger fracture each","description":"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35361","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85247","name":"Clot factor viii multimetric","description":"Clotting; factor viii, von willebrand factor, multimetric analysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25929","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; secondary closure or scar revision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85025","name":"Complete cbc w/auto diff wbc","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count) and automated differential wbc count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99391","name":"Per pm reeval est pat infant","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0303","name":"Hosp bed hvy dty xtra wide","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85597","name":"Phospholipid pltlt neutraliz","description":"Phospholipid neutralization; platelet","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80408","name":"Aldosterone suppression eval","description":"Aldosterone suppression evaluation panel (eg, saline infusion) this panel must include the following: aldosterone (82088 x 2) renin (84244 x 2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27396","name":"Transplant of thigh tendon","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); single tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63688","name":"Rev/rmv imp sp npg/r dtch cn","description":"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51865","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22859","name":"Insj biomechanical device","description":"Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70554","name":"Fmri brain by tech","description":"Magnetic resonance imaging, brain, functional mri; including test selection and administration of repetitive body part movement and/or visual stimulation, not requiring physician or psychologist administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82642","name":"Dihydrotestosterone","description":"Dihydrotestosterone (dht)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5069.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76857","name":"Us exam pelvic limited","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"12053","name":"Intmd rpr face/mm 5.1-7.5 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93270","name":"Remote 30 day ecg rev/report","description":"External patient and, when performed, auto activated electrocardiographic rhythm derived event recording with symptom-related memory loop with remote download capability up to 30 days, 24-hour attended monitoring; recording (includes connection, recording, and disconnection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93041","name":"Rhythm ecg tracing","description":"Rhythm ecg, 1-3 leads; tracing only without interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83896","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51865","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25246","name":"Injection for wrist x-ray","description":"Injection procedure for wrist arthrography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4465","name":"Non-elastic extremity binder","description":"Non-elastic binder for extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32160","name":"Open chest heart massage","description":"Thoracotomy; with cardiac massage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21138","name":"Rdctj forehead cntrg&prostc","description":"Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31625","name":"Bronchoscopy w/biopsy(s)","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69820","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97606","name":"Neg prs wnd ther dme>50 sqcm","description":"Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (dme), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater than 50 square centimeters","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34714","name":"Opn fem art expos cndt crtj","description":"Open femoral artery exposure with creation of conduit for delivery of endovascular prosthesis or for establishment of cardiopulmonary bypass, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26485","name":"Transplant palm tendon","description":"Transfer or transplant of tendon, palmar; without free tendon graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33368","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1391","name":"Oxygen concentrator, dual","description":"Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44135","name":"Intestine transplnt cadaver","description":"Intestinal allotransplantation; from cadaver donor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19282","name":"Perq device breast ea imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23665","name":"Cltx sho dslc fx gr hmrl tbr","description":"Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44126","name":"Enterectomy w/o taper cong","description":"Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89310","name":"Semen analysis w/count","description":"Semen analysis; motility and count (not including huhner test)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L9900","name":"O&p supply/accessory/service","description":"Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs l code","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01250","name":"Anes all px nrv musc upr leg","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3839.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93571","name":"Iv dop vel&/press c flo 1st","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; initial vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44100","name":"Biopsy of bowel","description":"Biopsy of intestine by capsule, tube, peroral (1 or more specimens)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72191","name":"Ct angiograph pelv w/o&w/dye","description":"Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2335.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22102","name":"Remove part lumbar vertebra","description":"Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33881","name":"Evasc rpr ta ndgft xcov lsa","description":"Endovascular repair of thoracic aorta, including pre-procedure sizing and device selection, nonselective catheterization(s), all associated radiological supervision and interpretation; by deployment of an aorto-aortic tube endograft not involving coverage of the left subclavian artery origin and all","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82633","name":"Desoxycorticosterone","description":"Desoxycorticosterone, 11-","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4680.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31084","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77021","name":"Mri guidance ndl plmt rs&i","description":"Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86356","name":"Mononuclear cell antigen","description":"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11101","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46707","name":"Repair anorectal fist w/plug","description":"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [sis])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67027","name":"Implant eye drug system","description":"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6025","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63700","name":"Repair of spinal herniation","description":"Repair of meningocele; less than 5 cm diameter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85540","name":"Wbc alkaline phosphatase","description":"Leukocyte alkaline phosphatase with count","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36560","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; younger than 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54000","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51101","name":"Drain bladder by trocar/cath","description":"Aspiration of bladder; by trocar or intracatheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93289","name":"Interrog device eval heart","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including anal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27357","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44402","name":"Colonoscopy w/stent plcmt","description":"Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92996","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53410","name":"Reconstruction of urethra","description":"Urethroplasty, 1-stage reconstruction of male anterior urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75960","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93015","name":"Cv stress test supvj i&r","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; with supervision, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01474","name":"Anes gastrocnemius recession","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95076","name":"Ingest challenge ini 120 min","description":"Ingestion challenge test (sequential and incremental ingestion of test items, eg, food, drug or other substance); initial 120 minutes of testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21240","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4918.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43644","name":"Lap gastric bypass/roux-en-y","description":"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and roux-en-y gastroenterostomy (roux limb 150 cm or less)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57423","name":"Repair paravag defect lap","description":"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92273","name":"Full field erg w/i&r","description":"Electroretinography (erg), with interpretation and report; full field (ie, fferg, flash erg, ganzfeld erg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81343","name":"Ppp2r2b gen detc abnor allel","description":"Ppp2r2b (protein phosphatase 2 regulatory subunit bbeta) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83615","name":"Lactate (ld) (ldh) enzyme","description":"Lactate dehydrogenase (ld), (ldh);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21400","name":"Closed tx orbit w/o manipulj","description":"Closed treatment of fracture of orbit, except blowout; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61534","name":"Removal of brain lesion","description":"Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70480","name":"Ct orbit/ear/fossa w/o dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63270","name":"Excise intrspinl lesion crvl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5510","name":"Compression form shoe insert","description":"For diabetics only, direct formed, compression molded to patients foot without external heat source, multiple-density insert(s) prefabricated, per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66635","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; optical (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77771","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 2-12 channels","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86406","name":"Particle agglut antbdy titr","description":"Particle agglutination; titer, each antibody","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22556","name":"Arthrd ant ntrbd min dsc thc","description":"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28735","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20972","name":"Bone/skin graft metatarsal","description":"Free osteocutaneous flap with microvascular anastomosis; metatarsal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27079","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92019","name":"Lmtd oph exam general anes","description":"Ophthalmological examination and evaluation, under general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15136","name":"Drm agrft f/s/n/h/f/g/m ea","description":"Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36221","name":"Place cath thoracic aorta","description":"Non-selective catheter placement, thoracic aorta, with angiography of the extracranial carotid, vertebral, and/or intracranial vessels, unilateral or bilateral, and all associated radiological supervision and interpretation, includes angiography of the cervicocerebral arch, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76883","name":"Us nrv&acc strux 1xtr compre","description":"Ultrasound, nerve(s) and accompanying structures throughout their entire anatomic course in one extremity, comprehensive, including real-time cine imaging with image documentation, per extremity","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31631","name":"Bronchoscopy dilate w/stent","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with placement of tracheal stent(s) (includes tracheal/bronchial dilation as required)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81310","name":"Npm1 gene","description":"Npm1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95726","name":"Eeg phy/qhp>84 hr w/veeg","description":"Electroencephalogram (eeg), continuous recording, physician or other qualified health care professional review of recorded events, analysis of spike and seizure detection, interpretation, and summary report, complete study; greater than 84 hours of eeg recording, with video (veeg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99356","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0221T","name":"Plmt post facet implt lumb","description":"Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65820","name":"Goniotomy","description":"Goniotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34709","name":"Plmt xtn prosth evasc rpr","description":"Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselec","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27358","name":"Remove femur lesion/fixation","description":"Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (list in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20822","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1503.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25135","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64570","name":"Remove vagus n eltrd","description":"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00625","name":"Anes thrc spine wo 1lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61001","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15758","name":"Free fascial flap microvasc","description":"Free fascial flap with microvascular anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30450","name":"Revision of nose","description":"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90818","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15826","name":"Rhytidectomy glblr frn lines","description":"Rhytidectomy; glabellar frown lines","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73221","name":"Mri joint upr extrem w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36585","name":"Replace picvad cath","description":"Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22510","name":"Perq cervicothoracic inject","description":"Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5960.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"37250","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53400","name":"Revise urethra stage 1","description":"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, johannsen type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92928","name":"Prq tcat plmt ntrac st 1 les","description":"Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, single major coronary artery and/or its branch(es); 1 lesion involving 1 or more coronary segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4376.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0247T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32660","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4193","name":"Parenteral sol 52-73 gm prot","description":"Parenteral nutrition solution; compounded amino acid and carbohydrates with electrolytes, trace elements, and vitamins, including preparation, any strength, 52 to 73 grams of protein - premix","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45333","name":"Sigmoidoscopy & polypectomy","description":"Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95927","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in the trunk or head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13122","name":"Cmplx rpr s/a/l addl 5 cm/>","description":"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69676","name":"Remove middle ear nerve","description":"Tympanic neurectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34711","name":"Dlyd plmt xtn prosth ea addl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33985","name":"Ecmo/ecls rmvl ctr cannula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; removal of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0398","name":"Home sleep test/type 2 porta","description":"Home sleep study test (hst) with type ii portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96406","name":"Chemo intralesional over 7","description":"Chemotherapy administration; intralesional, more than 7 lesions","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8879.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86153","name":"Cell enumeration phys interp","description":"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0868","name":"Pwc gp 4 std seat/back","description":"Power wheelchair, group 4 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29904","name":"Subtalar arthro w/fb rmvl","description":"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1483.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"59400","name":"Obstetrical care","description":"Routine obstetric care including antepartum care, vaginal delivery (with or without episiotomy, and/or forceps) and postpartum care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33860","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76140","name":"X-ray consultation","description":"Consultation on x-ray examination made elsewhere, written report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55920","name":"Place needles pelvic for rt","description":"Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93923","name":"Upr/lxtr art stdy 3+ lvls","description":"Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional doppler wave","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89049","name":"Chct for mal hyperthermia","description":"Caffeine halothane contracture test (chct) for malignant hyperthermia susceptibility, including interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01810","name":"Anes px nrv musc f/arm wrst","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61783","name":"Scan proc spinal","description":"Stereotactic computer-assisted (navigational) procedure; spinal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66720","name":"Destruction ciliary body","description":"Ciliary body destruction; cryotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2595.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21011","name":"Exc face les sc <2 cm","description":"Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96904","name":"Whole body photography","description":"Whole body integumentary photography, for monitoring of high risk patients with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a personal or familial history of melanoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54115","name":"Treatment of penis lesion","description":"Removal foreign body from deep penile tissue (eg, plastic implant)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82960","name":"Test for g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); screen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22612","name":"Arthrd pst tq 1ntrspc lumbar","description":"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99368","name":"Team conf w/o pat by hc pro","description":"Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47612","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with choledochoenterostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37197","name":"Remove intrvas foreign body","description":"Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, fractured venous or arterial catheter), includes radiological supervision and interpretation, and imaging guidance (ultrasound or fluoroscopy), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27364","name":"Resect thigh/knee tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of thigh or knee area; 5 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63182","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01714","name":"Anes nrv msc upr a&e tnplsty","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41872","name":"Gingivoplasty each quadrant","description":"Gingivoplasty, each quadrant (specify)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2723.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15574","name":"Pedcle fh/ch/ch/m/n/ax/g/h/f","description":"Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76813","name":"Ob us nuchal meas 1 gest","description":"Ultrasound, pregnant uterus, real time with image documentation, first trimester fetal nuchal translucency measurement, transabdominal or transvaginal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42405","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; incisional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0080","name":"Care manag h vst new pt 75 m","description":"Extensive (75 minutes) care management home visit for a new patient. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27356","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58345","name":"Reopen fallopian tube","description":"Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99605","name":"Mtms by pharm np 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, new patient","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58544","name":"Lsh w/t/o uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62162","name":"Remove colloid cyst w/scope","description":"Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, including placement of external ventricular catheter for drainage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35472","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12016","name":"Rpr fe/e/en/l/m 12.6-20.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36568","name":"Insj picc <5 yr w/o imaging","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, without imaging guidance; younger than 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54055","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86153","name":"Cell enumeration phys interp","description":"Cell enumeration using immunologic selection and identification in fluid specimen (eg, circulating tumor cells in blood); physician interpretation and report, when required","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66850","name":"Removal of lens material","description":"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46917","name":"Laser surgery anal lesions","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36580","name":"Replace cvad cath","description":"Replacement, complete, of a non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1470.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32220","name":"Release of lung","description":"Decortication, pulmonary (separate procedure); total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69320","name":"Rebuild outer ear canal","description":"Reconstruction external auditory canal for congenital atresia, single stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93461","name":"R&l hrt art/ventricle angio","description":"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, cath","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92549","name":"Cdp-sot 6 cond w/i&r mct&adt","description":"Computerized dynamic posturography sensory organization test (cdp-sot), 6 conditions (ie, eyes open, eyes closed, visual sway, platform sway, eyes closed platform sway, platform and visual sway), including interpretation and report; with motor control test (mct) and adaptation test (adt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26542","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38550","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00940","name":"Anes vaginal px nos","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35681","name":"Composite byp grft pros&vein","description":"Bypass graft; composite, prosthetic and vein (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5429.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31623","name":"Dx bronchoscope/brush","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4250","name":"Urine reagent strips/tablets","description":"Urine test or reagent strips or tablets (100 tablets or strips)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53200","name":"Biopsy of urethra","description":"Biopsy of urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32552","name":"Remove lung catheter","description":"Removal of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65765","name":"Keratophakia","description":"Keratophakia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25455","name":"Epiphysl arrst dstl rds&ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius and ulna","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61340","name":"Subtemporal cranial dcmprn","description":"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1314.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36870","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1788","name":"Port, indwelling, imp","description":"Port, indwelling (implantable)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22220","name":"Osteot dsc ant 1 vrt sgm crv","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"Esrd svc pr day pt <2","description":"End-stage renal disease (esrd) related services for dialysis less than a full month of service, per day; for patients younger than 2 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81327","name":"Sept9 gen prmtr mthyltn alys","description":"Sept9 (septin9) (eg, colorectal cancer) promoter methylation analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69440","name":"Exploration of middle ear","description":"Middle ear exploration through postauricular or ear canal incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57460","name":"Bx of cervix w/scope leep","description":"Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84181","name":"Western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11403","name":"Exc tr-ext b9+marg 2.1-3cm","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58570","name":"Tlh uterus 250 g or less","description":"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62281","name":"Treat spinal cord lesion","description":"Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67218","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35454","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90809","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21310","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32504","name":"Resect apical lung tum/chest","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; with chest wall reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61885","name":"Insrt/redo neurostim 1 array","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78430","name":"Myocrd img pet rst/strs w/ct","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0448T","name":"Remvl insj impltbl gluc sens","description":"Removal of implantable interstitial glucose sensor with creation of subcutaneous pocket at different anatomic site and insertion of new implantable sensor, including system activation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35538","name":"Art byp grft aortobi-iliac","description":"Bypass graft, with vein; aortobi-iliac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42894","name":"Revision of pharyngeal walls","description":"Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92134","name":"Cptrz oph dx img pst sgm rta","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; retina","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33274","name":"Tcat insj/rpl perm ldls pm","description":"Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50437","name":"Dilat xst trc new access rcs","description":"Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed; including new access into the renal collecting sys","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82274","name":"Assay test for blood fecal","description":"Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0329","name":"Electromagntic tx for ulcers","description":"Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90468","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35151","name":"Repair defect of artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, popliteal artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24153","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77422","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4220","name":"Parenteral supply kit premix","description":"Parenteral nutrition supply kit; premix, per day","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81174","name":"Ar gene known famil variant","description":"Ar (androgen receptor) (eg, spinal and bulbar muscular atrophy, kennedy disease, x chromosome inactivation) gene analysis; known familial variant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2793.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90827","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C8900","name":"Mra w/cont, abd","description":"Magnetic resonance angiography with contrast, abdomen","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25447","name":"Arthrp ntrcrp/crp/mtcr ntrps","description":"Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95870","name":"Ndl emg lmtd std musc 1 xtr","description":"Needle electromyography; limited study of muscles in 1 extremity or non-limb (axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial nerve supplied muscles, or sphincters","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25645","name":"Optx crpl fx oth/thn scph ea","description":"Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), each bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43240","name":"Egd w/transmural drain cyst","description":"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64611","name":"Chemodenerv saliv glands","description":"Chemodenervation of parotid and submandibular salivary glands, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6221","name":"Gauze > 48 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80061","name":"Lipid panel","description":"Lipid panel this panel must include the following: cholesterol, serum, total (82465) lipoprotein, direct measurement, high density cholesterol (hdl cholesterol) (83718) triglycerides (84478)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36012","name":"Place catheter in vein","description":"Selective catheter placement, venous system; second order, or more selective, branch (eg, left adrenal vein, petrosal sinus)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20700","name":"Mnl prep&insj dp rx dlvr dev","description":"Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98960","name":"Edu&trn pt self-mgmt nqhp 1","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient","date_of_service":"2026-06-06","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":["U3","U1"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G9044","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32609","name":"Thoracoscopy w/bx pleura","description":"Thoracoscopy; with biopsy(ies) of pleura","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99437","name":"Chrnc care mgmt phys ea addl","description":"Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or funct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63190","name":"Incise spine nrv >2 segmnts","description":"Laminectomy with rhizotomy; more than 2 segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65757","name":"Prep corneal endo allograft","description":"Backbench preparation of corneal endothelial allograft prior to transplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40845","name":"Reconstruction of mouth","description":"Vestibuloplasty; complex (including ridge extension, muscle repositioning)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4719","name":"Y set tubing","description":"Y set tubing for peritoneal dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35632","name":"Bpg ilio-celiac","description":"Bypass graft, with other than vein; ilio-celiac","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76125","name":"Cine/video x-rays add-on","description":"Cineradiography/videoradiography to complement routine examination (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10009","name":"Fna bx w/ct gdn 1st les","description":"Fine needle aspiration biopsy, including ct guidance; first lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50431","name":"Njx px nfrosgrm &/urtrgrm","description":"Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (eg, ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; existing access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26433","name":"Repair finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95982","name":"Io ga n-stim subsq w/reprog","description":"Electronic analysis of implanted neurostimulator pulse generator system (eg, rate, pulse amplitude and duration, configuration of wave form, battery status, electrode selectability, output modulation, cycling, impedance and patient measurements) gastric neurostimulator pulse generator/transmitter; s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99379","name":"Nursing fac care supervision","description":"Supervision of a nursing facility patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, comm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17282","name":"Dstr mal ls f/e/e/n/l/m1.1-2","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36260","name":"Insertion of infusion pump","description":"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2406.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92561","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95810","name":"Polysom 6/> yrs 4/> param","description":"Polysomnography; age 6 years or older, sleep staging with 4 or more additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44721","name":"Prep donor intestine/artery","description":"Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; arterial anastomosis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27357","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1100","name":"Whchr s-recl fxd arm leg res","description":"Semi-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28345","name":"Repair webbed toe(s)","description":"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47570","name":"Laparo cholecystoenterostomy","description":"Laparoscopy, surgical; cholecystoenterostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26607","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3150.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64462","name":"Pvb thoracic 2nd+ inj site","description":"Paravertebral block (pvb) (paraspinous block), thoracic; second and any additional injection site(s) (includes imaging guidance, when performed) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46601","name":"Diagnostic anoscopy","description":"Anoscopy; diagnostic, with high-resolution magnification (hra) (eg, colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or washing, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10060","name":"I&d abscess simple/single","description":"Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41105","name":"Biopsy of tongue","description":"Biopsy of tongue; posterior one-third","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"80170","name":"Assay of gentamicin","description":"Gentamicin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27268","name":"Cltx thigh fx w/mnpj","description":"Closed treatment of femoral fracture, proximal end, head; with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95705","name":"Eeg w/o vid 2-12 hr unmntr","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, 2-12 hours; unmonitored","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87804","name":"Influenza assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; influenza","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0144A","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82331","name":"Calcium infusion test","description":"Calcium; after calcium infusion test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61323","name":"Crnec/crnot dcmprv w/lobec","description":"Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24586","name":"Optx partclr fx&/dislc elbow","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2088","name":"Off base opioid tx, add30","description":"Office-based treatment for opioid use disorder, including care coordination, individual therapy and group therapy and counseling; each additional 30 minutes beyond the first 120 minutes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"97552","name":"Group caregiver training","description":"Group caregiver training in strategies and techniques to facilitate the patients functional performance in the home or community (eg, activities of daily living [adls], instrumental adls [iadls], transfers, mobility, communication, swallowing, feeding, problem solving, safety practices) (without the","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53850","name":"Prostatic microwave thermotx","description":"Transurethral destruction of prostate tissue; by microwave thermotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20525","name":"Rmvl fb musc/tdn deep/comp","description":"Removal of foreign body in muscle or tendon sheath; deep or complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2718.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28120","name":"Part removal of ankle/heel","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4520","name":"Incontinence garment anytype","description":"Incontinence garment, any type, (e.g., brief, diaper), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34844","name":"Endovasc visc aorta 4 graft","description":"Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31553","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, younger than 12 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81312","name":"Pabpn1 gene detc abnor allel","description":"Pabpn1 (poly[a] binding protein nuclear 1) (eg, oculopharyngeal muscular dystrophy) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01444","name":"Anes px art knee&pop exc&grf","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal excision and graft or repair for occlusion or aneurysm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69718","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6221","name":"Gauze > 48 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28119","name":"Removal of heel spur","description":"Ostectomy, calcaneus; for spur, with or without plantar fascial release","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23700","name":"Mnpj anes sho jt fixj aprats","description":"Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25425","name":"Repair/graft radius or ulna","description":"Repair of defect with autograft; radius or ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76145","name":"Med physic dos eval rad exps","description":"Medical physics dose evaluation for radiation exposure that exceeds institutional review threshold, including report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26665","name":"Treat thumb fracture","description":"Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95974","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28092","name":"Removal of toe lesions","description":"Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (eg, cyst or ganglion); toe(s), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39010","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99144","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69320","name":"Rebuild outer ear canal","description":"Reconstruction external auditory canal for congenital atresia, single stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42826","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; age 12 or over","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21026","name":"Excision of facial bone(s)","description":"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43216","name":"Esophagoscopy lesion removal","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28400","name":"Cltx calcaneal fx w/o mnpj","description":"Closed treatment of calcaneal fracture; without manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34710","name":"Dlyd plmt xtn prosth 1st vsl","description":"Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63250","name":"Revise spinal cord vsls crvl","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67450","name":"Explore/biopsy eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); for exploration, with or without biopsy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97032","name":"Appl modality 1+estim ea 15","description":"Application of a modality to 1 or more areas; electrical stimulation (manual), each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33216","name":"Insert 1 electrode pm-defib","description":"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62327","name":"Njx interlaminar lmbr/sac","description":"Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75565","name":"Card mri veloc flow mapping","description":"Cardiac magnetic resonance imaging for velocity flow mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63740","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S1040","name":"Cranial remolding orthosis","description":"Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26545","name":"Reconstruct finger joint","description":"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36147","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3332.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35216","name":"Rpr blvsl dir ntrthrc wo byp","description":"Repair blood vessel, direct; intrathoracic, without bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33504","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6215","name":"Foam dressing wound filler","description":"Foam dressing, wound filler, sterile, per gram","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8052.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2793.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93650","name":"Icar cath abltj av node func","description":"Intracardiac catheter ablation of atrioventricular node function, atrioventricular conduction for creation of complete heart block, with or without temporary pacemaker placement","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61531","name":"Implant brain electrodes","description":"Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90959","name":"Esrd serv 1 vst p mo 12-19","description":"End-stage renal disease (esrd) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 1 face-to-face visit by a physician or other qualified health care professional per mont","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49580","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3217","name":"Ladies shoes hightop depth i","description":"Orthopedic footwear, ladies shoe, hightop, depth inlay, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45327","name":"Proctosigmoidoscopy w/stent","description":"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82946","name":"Glucagon tolerance test","description":"Glucagon tolerance test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00813","name":"Anes upr lwr gi ndsc px","description":"Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31237","name":"Nsl/sins ndsc surg bx polypc","description":"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0268","name":"Removal of impacted wax md","description":"Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33622","name":"Redo compl cardiac anomaly","description":"Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left pulmonary bands (eg, hybrid approach stage 2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91110","name":"Gi trc img intral esoph-ile","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus through ileum, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15758","name":"Free fascial flap microvasc","description":"Free fascial flap with microvascular anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97004","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96132","name":"Nrpsyc tst eval phys/qhp 1st","description":"Neuropsychological testing evaluation services by physician or other qualified health care professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the pati","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65782","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95938","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44008.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46751","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; child","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31588","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82810","name":"Blood gases o2 sat only","description":"Gases, blood, o2 saturation only, by direct measurement, except pulse oximetry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2062.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11446","name":"Exc face-mm b9+marg >4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3288.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60220","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57285","name":"Repair paravag defect vag","description":"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9980","name":"Remote e/m new pt 30 mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33991","name":"Insj perq vad l hrt artl&ven","description":"Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00752","name":"Anes hrna rpr lmbr&vnt&/dehs","description":"Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99225","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28043","name":"Exc foot/toe tum sc < 1.5 cm","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58670","name":"Laparoscopy tubal cautery","description":"Laparoscopy, surgical; with fulguration of oviducts (with or without transection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73718","name":"Mri lower extremity w/o dye","description":"Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76805","name":"Ob us >/= 14 wks sngl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42972","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1240","name":"Whchr litwt det arm leg rest","description":"Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75665","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52300","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82143","name":"Amniotic fluid scan","description":"Amniotic fluid scan (spectrophotometric)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88107","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3544.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87622","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99116","name":"Anes comp tot bdy hypthrm","description":"Anesthesia complicated by utilization of total body hypothermia (list separately in addition to code for primary anesthesia procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32506","name":"Wedge resect of lung add-on","description":"Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0148T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37735","name":"Lig&div&compl strpg saph vn","description":"Ligation and division and complete stripping of long or short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81284","name":"Fxn gene detc abnor alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41017","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61581","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93572","name":"Iv dop vel&/press c flo ea","description":"Intravascular doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress, when performed; each additional vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47010","name":"Hepatot opn drg absc/cst 1/2","description":"Hepatotomy, for open drainage of abscess or cyst, 1 or 2 stages","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33507","name":"Repair art intramural","description":"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28715.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V5266","name":"Battery for hearing device","description":"Battery for use in hearing device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93893","name":"Tcd std icr art ven-art shnt","description":"Transcranial doppler study of the intracranial arteries; venous-arterial shunt detection with intravenous microbubble injection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E1340","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3157.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43269","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1035","name":"Patient transfer system <300","description":"Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6763.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0086","name":"Care man home care plan 30 m","description":"Limited (30 minutes) care management home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19368","name":"Brst rcnstj 1pdcl tram anast","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap, requiring separate microvascular anastomosis (supercharging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95250","name":"Cont gluc mntr phys/qhp eqp","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; physician or other qualified health care professional (office) provided equipment, sensor placement, hook-up, calibration of monitor, patient training, removal of sensor, and pr","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95967","name":"Meg evoked each addl","description":"Magnetoencephalography (meg), recording and analysis; for evoked magnetic fields, each additional modality (eg, sensory, motor, language, or visual cortex localization) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1571.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44055","name":"Correct malrotation of bowel","description":"Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, ladd procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54164","name":"Frenulotomy of penis","description":"Frenulotomy of penis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7830.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96368","name":"Ther/diag concurrent inf","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4534","name":"Youth size pull-on","description":"Youth sized disposable incontinence product, protective underwear/pull-on, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77306","name":"Telethx isodose plan simple","description":"Teletherapy isodose plan; simple (1 or 2 unmodified ports directed to a single area of interest), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0255","name":"Hospital bed var ht w/ mattr","description":"Hospital bed, variable height, hi-lo, with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22633","name":"Arthrd cmbn 1ntrspc lumbar","description":"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1642.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0446T","name":"Insj impltbl glucose sensor","description":"Creation of subcutaneous pocket with insertion of implantable interstitial glucose sensor, including system activation and patient training","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47383","name":"Perq abltj lvr cryoablation","description":"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5288.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97802","name":"Medical nutrition indiv in","description":"Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86000","name":"Agglutinins febrile antigen","description":"Agglutinins, febrile (eg, brucella, francisella, murine typhus, q fever, rocky mountain spotted fever, scrub typhus), each antigen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33390","name":"Valvuloplasty aortic valve","description":"Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural resuspension)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25624","name":"Cltx carpl scphd fx w/mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31805","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; intrathoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49611","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); second stage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54200","name":"Injection px peyronie ds","description":"Injection procedure for peyronie disease;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01820","name":"Anes clsd px rds u/w/h bones","description":"Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T5999","name":"Supply, nos","description":"Supply, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95885","name":"Musc tst done w/nerv tst lim","description":"Needle electromyography, each extremity, with related paraspinal areas, when performed, done with nerve conduction, amplitude and latency/velocity study; limited (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68841","name":"Insj rx elut implt lac canal","description":"Insertion of drug-eluting implant, including punctal dilation when performed, into lacrimal canaliculus, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12017","name":"Rpr fe/e/en/l/m 20.1-30.0 cm","description":"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21461","name":"Optx mndblr fx wo ntrdntl","description":"Open treatment of mandibular fracture; without interdental fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"12047","name":"Intmd rpr n-hf/genit >30.0cm","description":"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76979","name":"Us trgt dyn mbubb ea addl","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); each additional lesion with separate injection (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21047","name":"Excise lwr jaw cyst w/repair","description":"Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50075","name":"Nl rmvl lg staghorn calculus","description":"Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2492.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75960","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71275","name":"Ct angiography chest","description":"Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01967","name":"Neuraxl lbr anes vag dlvr","description":"Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"Home/res vst new high mdm 75","description":"Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45392","name":"Colonoscopy w/endoscopic fnb","description":"Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95065","name":"Dir nsl mucous membrane test","description":"Direct nasal mucous membrane test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2406.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31571","name":"Laryngoscop w/vc inj + scope","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64712","name":"Revision of sciatic nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15734","name":"Muscle-skin graft trunk","description":"Muscle, myocutaneous, or fasciocutaneous flap; trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0343","name":"Laparotomy islet cell transp","description":"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64449","name":"Njx aa&/strd lmbr plex nfs","description":"Injection(s), anesthetic agent(s) and/or steroid; lumbar plexus, posterior approach, continuous infusion by catheter (including catheter placement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21261","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96154","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0190T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87281","name":"Pneumocystis carinii ag if","description":"Infectious agent antigen detection by immunofluorescent technique; pneumocystis carinii","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78800","name":"Rp loclzj tum 1 area 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, single area (eg, head, neck, chest, pelvis), single day imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82495","name":"Assay of chromium","description":"Chromium","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42970","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); simple, with posterior nasal packs, with or without anterior packs and/or cautery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4248","name":"Chlorhexidine antisept","description":"Chlorhexidine containing antiseptic, 1 ml","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2015","name":"Post-d/c care plan overs 60m","description":"Comprehensive (60 mins) home care plan oversight. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility.)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92225","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24587","name":"Optx partclr fx&/dslc elbw w","description":"Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius); with implant arthroplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43213","name":"Esophagoscopy retro balloon","description":"Esophagoscopy, flexible, transoral; with dilation of esophagus, by balloon or dilator, retrograde (includes fluoroscopic guidance, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0237T","name":"Trluml perip athrc brchiocph","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27178","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0420","name":"Ed svc ckd ind per session","description":"Face-to-face educational services related to the care of chronic kidney disease; individual, per session, per one hour","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24071","name":"Exc arm/elbow les sc 3 cm/>","description":"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36819","name":"Av fuse uppr arm basilic","description":"Arteriovenous anastomosis, open; by upper arm basilic vein transposition","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88325","name":"Consltj compre rvw rec reprt","description":"Consultation, comprehensive, with review of records and specimens, with report on referred material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32503","name":"Resect apical lung tumor","description":"Resection of apical lung tumor (eg, pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when performed; without chest wall reconstruction(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00934","name":"Anes rad amp penis ingun lym","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6239","name":"Hydrocolld drg > 48 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92286","name":"Ant sgm img i&r speclr mic","description":"Anterior segment imaging with interpretation and report; with specular microscopy and endothelial cell analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44364","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83009","name":"H pylori (c-13) blood","description":"Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, c-13)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49014","name":"Reexploration pelvic wound","description":"Re-exploration of pelvic wound with removal of preperitoneal pelvic packing, including repacking, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27630","name":"Removal of tendon lesion","description":"Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33236","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35458","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47720","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; direct","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99458","name":"Rpm tx mgmt ea addl 20 min","description":"Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (list separately in","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44660","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; without intestinal or bladder resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33523","name":"Cabg art-vein six or more","description":"Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more venous grafts (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"89225","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11786.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45347","name":"Sigmoidoscopy w/plcmt stent","description":"Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27502","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27601","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36901","name":"Intro cath dialysis circuit","description":"Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous out","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22865","name":"Rmvl tot arthrp 1ntrspc lmbr","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3909.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35045","name":"Repair defect of arm artery","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, radial or ulnar artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76936","name":"Echo guide for artery repair","description":"Ultrasound guided compression repair of arterial pseudoaneurysm or arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of lesion and imaging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28055","name":"Neurectomy foot","description":"Neurectomy, intrinsic musculature of foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22112","name":"Remove part thorax vertebra","description":"Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95939","name":"C motor evoked upr&lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); in upper and lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42205","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92979","name":"Endoluminl ivus oct c ea","description":"Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (ivus) or optical coherence tomography (oct) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (list separately in addition to co","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63702","name":"Repair of spinal herniation","description":"Repair of meningocele; larger than 5 cm diameter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77334","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; complex (irregular blocks, special shields, compensators, wedges, molds or casts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85421","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0148","name":"Scr c/v cyto, autosys, rescr","description":"Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15733","name":"Musc myoq/fscq flp h&n pedcl","description":"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26556","name":"Toe joint transfer","description":"Transfer, free toe joint, with microvascular anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50433","name":"Plmt nephroureteral catheter","description":"Placement of nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, new access","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"30462","name":"Revision of nose","description":"Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53230","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); female","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21026","name":"Excision of facial bone(s)","description":"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46948","name":"Int hrhc tranal dartlzj 2+","description":"Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21320","name":"Clsd tx nsl fx w/mnpj&stablj","description":"Closed treatment of nasal bone fracture with manipulation; with stabilization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9486","name":"Remote e/m est. pt 10mins","description":"Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward med","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19307","name":"Mast mod rad","description":"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24358","name":"Repair elbow w/deb open","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); debridement, soft tissue and/or bone, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19290","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95921","name":"Autonomic nrv parasym inervj","description":"Testing of autonomic nervous system function; cardiovagal innervation (parasympathetic function), including 2 or more of the following: heart rate response to deep breathing with recorded r-r interval, valsalva ratio, and 30:15 ratio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25455","name":"Epiphysl arrst dstl rds&ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius and ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99403","name":"Prev med cnsl indiv apprx 45","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27446","name":"Revision of knee joint","description":"Arthroplasty, knee, condyle and plateau; medial or lateral compartment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0146T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43268","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15330","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0515T","name":"Insj wcs lv compl sys","description":"Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; complete system (includes electrode and generator [transmitter and battery])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3588.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54411","name":"Remov/replc penis pros comp","description":"Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92650","name":"Aep scr auditory potential","description":"Auditory evoked potentials; screening of auditory potential with broadband stimuli, automated analysis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74363","name":"X-ray bile duct dilation","description":"Percutaneous transhepatic dilation of biliary duct stricture with or without placement of stent, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50120","name":"Pyelotomy w/exploration","description":"Pyelotomy; with exploration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19288","name":"Perq dev breast add mr guide","description":"Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including magnetic resonance guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36860","name":"External cannula declotting","description":"External cannula declotting (separate procedure); without balloon catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54112","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft greater than 5 cm in length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KL"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29836","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25830","name":"Arthrd dst rad/ul jt sgm rsc","description":"Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or without bone graft (eg, sauve-kapandji procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4478.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0733","name":"12-24hr sealed lead acid","description":"Power wheelchair accessory, 12 to 24 amp hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31253","name":"Nsl/sins ndsc total","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24140","name":"Partial exc bone humerus","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61798","name":"Srs cranial lesion complex","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33217","name":"Insert 2 electrode pm-defib","description":"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21925","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; deep","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76506","name":"Echo exam of head","description":"Echoencephalography, real time with image documentation (gray scale) (for determination of ventricular size, delineation of cerebral contents, and detection of fluid masses or other intracranial abnormalities), including a-mode encephalography as secondary component where indicated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59851","name":"Induced abortion 1+njx d&c","description":"Induced abortion, by 1 or more intra-amniotic injections (amniocentesis-injections), including hospital admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93619","name":"Comprehensive ep evaluation","description":"Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, his bundle recording, including insertion and repositioning of multiple electrode catheters, without induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27397","name":"Transplants of thigh tendons","description":"Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor to flexor); multiple tendons","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74022","name":"Radex compl aqt abd series","description":"Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect, decubitus), and a single view chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87521","name":"Hepatitis c probe&rvrs trnsc","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis c, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37184","name":"Prim art m-thrmbc 1st vsl","description":"Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); initial vessel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87620","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48140","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67971","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52334","name":"Create passage to kidney","description":"Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81025","name":"Urine pregnancy test","description":"Urine pregnancy test, by visual color comparison methods","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28008","name":"Incision of foot fascia","description":"Fasciotomy, foot and/or toe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4026.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32605","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4607.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57550","name":"Removal of residual cervix","description":"Excision of cervical stump, vaginal approach;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6978.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87906","name":"Nfct agt gntyp alys hiv1","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); hiv-1, other region (eg, integrase, fusion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21385","name":"Opn tx orbit fx transantral","description":"Open treatment of orbital floor blowout fracture; transantral approach (caldwell-luc type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29882","name":"Arthrs kne srg mnisc rpr m/l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15823","name":"Blepharp upr eyelid xcsv skn","description":"Blepharoplasty, upper eyelid; with excessive skin weighting down lid","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42720","name":"I&d absc phrngl ntraorl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82638","name":"Assay of dibucaine number","description":"Dibucaine number","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99149","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64680","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0250","name":"Md inr test revie inter mgmt","description":"Physician review, interpretation, and patient management of home inr testing for patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets medicare coverage criteria; testing not occurring more frequently than once a week; billing units of servic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93260","name":"Prgrmg dev eval impltbl sys","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; implantable subcutaneous lead d","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01272","name":"Anes px art femoral art lig","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; femoral artery ligation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4539","name":"Reuse diaper/brief any size","description":"Incontinence product, diaper/brief, reusable, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82270","name":"Occult blood feces","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00862","name":"Anes xtrprtl lwr abd rnl px","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21462","name":"Optx mndblr fx w/ntrdntl","description":"Open treatment of mandibular fracture; with interdental fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49203","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52343","name":"Cysto w/renal stricture tx","description":"Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4508.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L4380","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50810","name":"Fusion of ureter & bowel","description":"Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4269","name":"Spermicide","description":"Contraceptive supply, spermicide (e.g., foam, gel), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6086.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01930","name":"Anes ther ivntl rad ven nos","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47380","name":"Open ablate liver tumor rf","description":"Ablation, open, of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68530","name":"Clearance of tear duct","description":"Removal of foreign body or dacryolith, lacrimal passages","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77071","name":"Mnl appl strs jt radiography","description":"Manual application of stress performed by physician or other qualified health care professional for joint radiography, including contralateral joint if indicated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32608","name":"Thoracoscopy w/bx nodule","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1891.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0521T","name":"Interrog dev eval wcs ip","description":"Interrogation device evaluation (in person) with analysis, review and report, includes connection, recording, and disconnection per patient encounter, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93050","name":"Art pressure waveform analys","description":"Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform(s), digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity art","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4099","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86376","name":"Microsomal antibody each","description":"Microsomal antibodies (eg, thyroid or liver-kidney), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35493","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26426","name":"Repair finger/hand tendon","description":"Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76825","name":"Echo exam of fetal heart","description":"Echocardiography, fetal, cardiovascular system, real time with image documentation (2d), with or without m-mode recording;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15111","name":"Epidrm agrft t/a/l ea addl","description":"Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21079","name":"Impres&prep intrm obt prosth","description":"Impression and custom preparation; interim obturator prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43752","name":"Nasal/orogastric w/tube plmt","description":"Naso- or oro-gastric tube placement, requiring physicians skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36468","name":"Njx sclrsnt spider veins","description":"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90814","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36260","name":"Insertion of infusion pump","description":"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64721","name":"Carpal tunnel surgery","description":"Neuroplasty and/or transposition; median nerve at carpal tunnel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66160","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0294","name":"Hosp bed semi-elect w/ mattr","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92937","name":"Prq trluml revsc cab grf 1","description":"Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed, single major coronary artery and/or its branches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4535","name":"Disposable liner/shield/pad","description":"Disposable liner/shield/guard/pad/undergarment, for incontinence, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67912","name":"Correction eyelid w/implant","description":"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82810","name":"Blood gases o2 sat only","description":"Gases, blood, o2 saturation only, by direct measurement, except pulse oximetry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93225","name":"Xtrnl ecg rec<48 hrs rec","description":"External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; recording (includes connection, recording, and disconnection)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27510","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01173","name":"Anes opn rpr fx disrpj plvs","description":"Anesthesia for open repair of fracture disruption of pelvis or column fracture involving acetabulum","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2355.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4534","name":"Youth size pull-on","description":"Youth sized disposable incontinence product, protective underwear/pull-on, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72133","name":"Ct lumbar spine w/o & w/dye","description":"Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67966","name":"Revision of eyelid","description":"Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5626","name":"Test socket hip disarticulat","description":"Addition to lower extremity, test socket, hip disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93662","name":"Intracardiac ecg (ice)","description":"Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01432","name":"Anes px vn knee&pop av fstl","description":"Anesthesia for procedures on veins of knee and popliteal area; arteriovenous fistula","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94642","name":"Aerosol inhalation treatment","description":"Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33786","name":"Repair arterial trunk","description":"Total repair, truncus arteriosus (rastelli type operation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23035","name":"Incision bone cortex sho","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83914","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19282","name":"Perq device breast ea imag","description":"Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0265","name":"Hosp bed total electr w/ mat","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17315","name":"Mohs surg addl block","description":"Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), e","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35522","name":"Art byp grft axill-brachial","description":"Bypass graft, with vein; axillary-brachial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87534","name":"Hiv-1 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, direct probe technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34715","name":"Opn ax/subcla art expos","description":"Open axillary/subclavian artery exposure for delivery of endovascular prosthesis by infraclavicular or supraclavicular incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86704","name":"Hep b core antibody total","description":"Hepatitis b core antibody (hbcab); total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88364","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50951","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96136","name":"Psycl/nrpsyc tst phy/qhp 1st","description":"Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35600","name":"Open hrv uxtr art 1 sgm cab","description":"Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure, open","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3362.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49424","name":"Assess cyst contrast inject","description":"Contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58957","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0168","name":"Wound closure by adhesive","description":"Wound closure utilizing tissue adhesive(s) only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01610","name":"Anes all px nrv musc sho&ax","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37253","name":"Intrvasc us noncoronary addl","description":"Intravascular ultrasound (noncoronary vessel) during diagnostic evaluation and/or therapeutic intervention, including radiological supervision and interpretation; each additional noncoronary vessel (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82487","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67331","name":"Eye surgery follow-up add-on","description":"Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50785","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with vesico-psoas hitch or bladder flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57320","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; vaginal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27824","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36591","name":"Draw blood off venous device","description":"Collection of blood specimen from a completely implantable venous access device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8265","name":"Haberman feeder","description":"Haberman feeder for cleft lip/palate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37201","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53605","name":"Dilate urethra stricture","description":"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4798.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54400","name":"Insert semi-rigid prosthesis","description":"Insertion of penile prosthesis; non-inflatable (semi-rigid)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47630","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11606","name":"Exc tr-ext mal+marg >4 cm","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72142","name":"Mri neck spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89130","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50840","name":"Replace ureter by bowel","description":"Replacement of all or part of ureter by intestine segment, including intestine anastomosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43227","name":"Esophagoscopy control bleed","description":"Esophagoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3673","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61334","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"Basic vestibular evaluation","description":"Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27825","name":"Treat lower leg fracture","description":"Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"Esrd home pt serv p mo 12-19","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93293","name":"Pm phone r-strip device eval","description":"Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple lead pacemaker system, includes recording with and without magnet application with analysis, review and report(s) by a physician or other qualified health care professional, up to 90 days","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83071","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0109T","name":"Heat quant sensory test","description":"Quantitative sensory testing (qst), testing and interpretation per extremity; using heat-pain stimuli to assess small nerve fiber sensation and hyperalgesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95979","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0424","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93356","name":"Myocrd strain img spckl trck","description":"Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (list separately in addition to codes for echocardiography imaging)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4539","name":"Reuse diaper/brief any size","description":"Incontinence product, diaper/brief, reusable, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99463","name":"Same day nb discharge","description":"Initial hospital or birthing center care, per day, for evaluation and management of normal newborn infant admitted and discharged on the same date","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88720","name":"Bilirubin total transcut","description":"Bilirubin, total, transcutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90816","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61618","name":"Repair dura","description":"Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35632","name":"Bpg ilio-celiac","description":"Bypass graft, with other than vein; ilio-celiac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15321","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15830","name":"Exc excessive skin abdomen","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2042.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4874.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69631","name":"Repair eardrum structures","description":"Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8687","name":"Implt nrostm pls gen dua rec","description":"Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47143","name":"Prep donor liver whole","description":"Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; without triseg","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88367","name":"Insitu hybridization auto","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; initial single probe stain procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3912.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00811","name":"Anes lwr intst ndsc nos","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96366","name":"Ther/proph/diag iv inf addon","description":"Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15361","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22514","name":"Perq vertebral augmentation","description":"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64681","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24579","name":"Optx humrl cndylr fracture","description":"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93790","name":"Ambl bp mntr w/sw i&r","description":"Ambulatory blood pressure monitoring, utilizing report-generating software, automated, worn continuously for 24 hours or longer; review with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78802","name":"Rp loclzj tum whbdy 1 d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80053","name":"Comprehen metabolic panel","description":"Comprehensive metabolic panel this panel must include the following: albumin (82040) bilirubin, total (82247) calcium, total (82310) carbon dioxide (bicarbonate) (82374) chloride (82435) creatinine (82565) glucose (82947) phosphatase, alkaline (84075) potassium (84132) protein, total (84155) sodium ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77081","name":"Dxa bone density appendiculr","description":"Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26418","name":"Repair finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64778","name":"Digit nerve surgery add-on","description":"Excision of neuroma; digital nerve, each additional digit (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99284","name":"Emergency dept visit mod mdm","description":"Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24358","name":"Repair elbow w/deb open","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); debridement, soft tissue and/or bone, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91013","name":"Esophgl motil w/stim/perfus","description":"Esophageal motility (manometric study of the esophagus and/or gastroesophageal junction) study with interpretation and report; with stimulation or perfusion (eg, stimulant, acid or alkali perfusion) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30906","name":"Repeat control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87275","name":"Influenza b ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza b virus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01440","name":"Anes px art knee&pop nos","description":"Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93524","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78266","name":"Gstr empt img sm bwl&colon","description":"Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76376","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62272","name":"Ther spi pnxr drg csf","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6967.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26492","name":"Tendon transfer with graft","description":"Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77770","name":"Hdr rdncl ntrstl/icav brchtx","description":"Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; 1 channel","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93018","name":"Cv stress test i&r only","description":"Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80102","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0241U","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1999.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88386","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86665","name":"Epstein-barr capsid vca","description":"Antibody; epstein-barr (eb) virus, viral capsid (vca)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4533","name":"Youth size brief/diaper","description":"Youth sized disposable incontinence product, brief/diaper, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29879","name":"Arthrs kne srg abrasj arthrp","description":"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72083","name":"X-ray exam entire spi 4/5 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 4 or 5 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36556","name":"Insert non-tunnel cv cath","description":"Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01480","name":"Anes open px lower l/a/f nos","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G9678","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19380","name":"Revj reconstructed breast","description":"Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27076","name":"Resect hip tum incl acetabul","description":"Radical resection of tumor; ilium, including acetabulum, both pubic rami, or ischium and acetabulum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26862","name":"Fusion/graft of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93798","name":"Phys/qhp op car rhab w/ecg","description":"Physician or other qualified health care professional services for outpatient cardiac rehabilitation; with continuous ecg monitoring (per session)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33503","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43287","name":"Esphg dstl 2/3 w/laps moblj","description":"Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic e","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3003.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82157","name":"Assay of androstenedione","description":"Androstenedione","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0315","name":"Counsel immune <21  5-15 m","description":"Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29880","name":"Arthrs kne srg mnisectmy m&l","description":"Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69646","name":"Revise middle ear & mastoid","description":"Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68371","name":"Harvest eye tissue alograft","description":"Harvesting conjunctival allograft, living donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17276","name":"Dstr mal les s/n/h/f/g >4.0","description":"Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0522T","name":"Prgrmg dev eval wcs ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, wireless cardiac stimulator for left ventricular pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88373","name":"M/phmtrc alys ishquant/semiq","description":"Morphometric analysis, in situ hybridization (quantitative or semi-quantitative), using computer-assisted technology, per specimen; each additional single probe stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31634","name":"Bronch w/balloon occlusion","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (eg, fibrin glue), if performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4709","name":"Acid conc sol per gallon","description":"Acid concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29358","name":"Appl long leg cast brace","description":"Application of long leg cast brace","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22326","name":"Treat neck spine fracture","description":"Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28666","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5299.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38381","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; thoracic approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28100","name":"Removal of ankle/heel lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96445","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82552","name":"Assay of cpk in blood","description":"Creatine kinase (ck), (cpk); isoenzymes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11045","name":"Dbrdmt subq tiss each addl","description":"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00548","name":"Anes thrcm px trach&bronchi","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); intrathoracic procedures on the trachea and bronchi","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10238.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22552","name":"Arthrd ant ntrbd cervical ea","description":"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below c2, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36572","name":"Insj picc rs&i <5 yr","description":"Insertion of peripherally inserted central venous catheter (picc), without subcutaneous port or pump, including all imaging guidance, image documentation, and all associated radiological supervision and interpretation required to perform the insertion; younger than 5 years of age","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1429.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86735","name":"Mumps antibody","description":"Antibody; mumps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2301.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66830","name":"Removal of lens lesion","description":"Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99461","name":"Init nb em per day non-fac","description":"Initial care, per day, for evaluation and management of normal newborn infant seen in other than hospital or birthing center","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66989","name":"Xcpsl ctrc rmvl cplx insj 1+","description":"Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44376","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92950","name":"Heart/lung resuscitation cpr","description":"Cardiopulmonary resuscitation (eg, in cardiac arrest)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"22600","name":"Arthrd pst tq 1ntrspc crv","description":"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below c2 segment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17106","name":"Dstr cut vsc prlf les<10sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93294","name":"Rem interrog evl pm/ldls pm","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75809","name":"Nonvascular shunt x-ray","description":"Shuntogram for investigation of previously placed indwelling nonvascular shunt (eg, leveen shunt, ventriculoperitoneal shunt, indwelling infusion pump), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88121","name":"Cytp urine 3-5 probes cmptr","description":"Cytopathology, in situ hybridization (eg, fish), urinary tract specimen with morphometric analysis, 3-5 molecular probes, each specimen; using computer-assisted technology","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26412","name":"Repair/graft hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57110","name":"Vagnc compl rmvl vag wall","description":"Vaginectomy, complete removal of vaginal wall;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84630","name":"Assay of zinc","description":"Zinc","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24345","name":"Repr elbw med ligmnt w/tissu","description":"Repair medial collateral ligament, elbow, with local tissue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27691","name":"Revise lower leg tendon","description":"Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25635","name":"Cltx carpl fx w/mnpj ea b1","description":"Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); with manipulation, each bone","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27230","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00540","name":"Anes thoracotomy px nos","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"12057","name":"Intmd rpr face/mm >30.0 cm","description":"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87534","name":"Hiv-1 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80192","name":"Assay of procainamide","description":"Procainamide; with metabolites (eg, n-acetyl procainamide)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24071","name":"Exc arm/elbow les sc 3 cm/>","description":"Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14621.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1627.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93545","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27742","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; and distal femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15823","name":"Blepharp upr eyelid xcsv skn","description":"Blepharoplasty, upper eyelid; with excessive skin weighting down lid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64494","name":"Inj paravert f jnt l/s 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), lumbar or sacral; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28112","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; other metatarsal head (second, third or fourth)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92312","name":"Contact lens fitg aphakia ou","description":"Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67343","name":"Release eye tissue","description":"Release of extensive scar tissue without detaching extraocular muscle (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0019T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29807","name":"Sho arthrs srg rpr slap les","description":"Arthroscopy, shoulder, surgical; repair of slap lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11752","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29582","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76000","name":"Fluoroscopy <1 hr phys/qhp","description":"Fluoroscopy (separate procedure), up to 1 hour physician or other qualified health care professional time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81345","name":"Tert gene targeted seq alys","description":"Tert (telomerase reverse transcriptase) (eg, thyroid carcinoma, glioblastoma multiforme) gene analysis, targeted sequence analysis (eg, promoter region)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01969","name":"Anes c hyst flwg neuraxial","description":"Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (list separately in addition to code for primary procedure performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33141","name":"Heart tmr w/other procedure","description":"Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44366","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0317","name":"Prolong nursin fac eval 15m","description":"Prolonged nursing facility evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using time on the date of the primary service); each additional 15 minutes by the physician or qualified healthcare professional, with or without ","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4726","name":"Dialys sol fld vol > 5999cc","description":"Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4035","name":"Enteral feed supp pump per d","description":"Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"69706","name":"Nps surg dilat eust tube bi","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99242","name":"Off/op consltj new/est sf 20","description":"Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded.","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0675","name":"Pneumatic compression device","description":"Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4110.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27641","name":"Partial removal of fibula","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2215.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64893","name":"Nrv grf 1strnd arm/leg >4 cm","description":"Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1758","name":"Catheter, ureteral","description":"Catheter, ureteral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15951","name":"Exc trchntr pr ulc ostc","description":"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24600","name":"Tx clsd elbow dislc w/o anes","description":"Treatment of closed elbow dislocation; without anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3917.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00936","name":"Anes rad amp pns ingun&ilac","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61630","name":"Balo angioplasty icr perq","description":"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61576","name":"Skull base/brainstem surgery","description":"Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19340","name":"Insj breast implt sm d mast","description":"Insertion of breast implant on same day of mastectomy (ie, immediate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87483","name":"Cns dna amp probe type 12-25","description":"Infectious agent detection by nucleic acid (dna or rna); central nervous system pathogen (eg, neisseria meningitidis, streptococcus pneumoniae, listeria, haemophilus influenzae, e. coli, streptococcus agalactiae, enterovirus, human parechovirus, herpes simplex virus type 1 and 2, human herpesvirus 6","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26115","name":"Exc hand les sc < 1.5 cm","description":"Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95709","name":"Eeg w/o vid ea 12-26hr intmt","description":"Electroencephalogram (eeg), without video, review of data, technical description by eeg technologist, each increment of 12-26 hours; with intermittent monitoring and maintenance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21046","name":"Remove mandible cyst complex","description":"Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58563","name":"Hysteroscopy ablation","description":"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44135","name":"Intestine transplnt cadaver","description":"Intestinal allotransplantation; from cadaver donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5095.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4367.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99477","name":"Init day hosp neonate care","description":"Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, who requires intensive observation, frequent interventions, and other intensive care services","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63046","name":"Lam facetec & foramot thrc","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; thoracic","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0246T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0245T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34201","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4456.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22208","name":"Incis spine 3 column adl seg","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1339.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0436","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86360","name":"T cell absolute count/ratio","description":"T cells; absolute cd4 and cd8 count, including ratio","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87181","name":"Sc std agar dilution per agt","description":"Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01952","name":"Anes 2&3 burn 4-9% tbsa","description":"Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (tbsa) treated during anesthesia and surgery; between 4% and 9% of total body surface area","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17340","name":"Cryotherapy for acne","description":"Cryotherapy (co2 slush, liquid n2) for acne","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80050","name":"General health panel","description":"General health panel this panel must include the following: comprehensive metabolic panel (80053) blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29075","name":"Appl cst elbw fngr short arm","description":"Application, cast; elbow to finger (short arm)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01840","name":"Anes art f/arm wrst&hnd nos","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25073","name":"Exc forearm tum deep 3 cm/>","description":"Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83891","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28238","name":"Revision of foot tendon","description":"Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, kidner type procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53425","name":"Reconstruct urethra stage 2","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99478","name":"Sbsq ic vlbw inf<1,500 gm","description":"Subsequent intensive care, per day, for the evaluation and management of the recovering very low birth weight infant (present body weight less than 1,500 grams)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49606","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and closure, in operating room","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4215","name":"Sterile needle","description":"Needle, sterile, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28450","name":"Tx tarsal b1 fx w/o mnpj ea","description":"Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32701","name":"Thorax stereo rad targetw/tx","description":"Thoracic target(s) delineation for stereotactic body radiation therapy (srs/sbrt), (photon or particle beam), entire course of treatment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53235","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); male","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00562","name":"Anes px hrt w/pump age 1yr+","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator, age 1 year or older, for all noncoronary bypass procedures (eg, valve procedures) or for re-operation for coronary bypass more than 1 month after original operation","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50715","name":"Release of ureter","description":"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87530","name":"Hsv dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, quantification","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87550","name":"Mycobacteria dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0332","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4670","name":"Automatic bp monitor, dial","description":"Automatic blood pressure monitor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74270","name":"X-ray xm colon 1cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19294","name":"Prepj tum cav iort prtl mast","description":"Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (iort) concurrent with partial mastectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46280","name":"Remove anal fist complex","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52270","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; female","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86880","name":"Coombs test direct","description":"Antihuman globulin test (coombs test); direct, each antiserum","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"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":"2026-06-06","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":["SL","HA"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95962","name":"Electrode stim brain add-on","description":"Functional cortical and subcortical mapping by stimulation and/or recording of electrodes on brain surface, or of depth electrodes, to provoke seizures or identify vital brain structures; each additional hour of attendance by a physician or other qualified health care professional (list separately i","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93295","name":"Dev interrog remote 1/2/mlt","description":"Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21811","name":"Optx of rib fx w/fixj scope","description":"Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93566","name":"Njx car cth slctv rv/ra ang","description":"Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94644","name":"Cont inhlj tx 1st hour","description":"Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4542","name":"Small disposable underpad","description":"Incontinence product, disposable underpad, small size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49420","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43335","name":"Transthor diaphrag hern rpr","description":"Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; with implantation of mesh or other prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9505","name":"Tl201 thallium","description":"Thallium tl-201 thallous chloride, diagnostic, per millicurie","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99292","name":"Critical care addl 30 min","description":"Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01486","name":"Anes open total ankle rplcmt","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47535","name":"Conversion ext bil drg cath","description":"Conversion of external biliary drainage catheter to internal-external biliary drainage catheter, percutaneous, including diagnostic cholangiography when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70492","name":"Ct sft tsue nck w/o & w/dye","description":"Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26492","name":"Tendon transfer with graft","description":"Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83003","name":"Assay growth hormone (hgh)","description":"Growth hormone, human (hgh) (somatotropin)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85396","name":"Clotting assay whole blood","description":"Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), including use of any pharmacologic additive(s), as indicated, including interpretation and written report, per day","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95806","name":"Sleep study unatt&resp efft","description":"Sleep study, unattended, simultaneous recording of, heart rate, oxygen saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal movement)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00732","name":"Anes upr gi ndsc px ercp","description":"Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ercp)","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0118","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patient furnished under the direct supervision of an optometrist or ophthalmologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94618","name":"Pulmonary stress testing","description":"Pulmonary stress testing (eg, 6-minute walk test), including measurement of heart rate, oximetry, and oxygen titration, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"Esrd home pt serv p mo <2yrs","description":"End-stage renal disease (esrd) related services for home dialysis per full month, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52224","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm) lesion(s) with or without biopsy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88341","name":"Imhchem/imcytchm ea add antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain procedure (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97161","name":"Pt eval low complex 20 min","description":"Physical therapy evaluation: low complexity, requiring these components: a history with no personal factors and/or comorbidities that impact the plan of care; an examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1070.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27095","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; with anesthesia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1255.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63101","name":"Remove vert body dcmprn thrc","description":"Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37241","name":"Vasc embolize/occlude venous","description":"Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2458.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36473","name":"Endovenous mchnchem 1st vein","description":"Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, mechanochemical; first vein treated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4526.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4480","name":"Vabra aspirator","description":"Vabra aspirator","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01270","name":"Anes px arteries upr leg nos","description":"Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70543","name":"Mri orbt/fac/nck w/o &w/dye","description":"Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48150","name":"Partial removal of pancreas","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2609.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44615","name":"Intestinal stricturoplasty","description":"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33619","name":"Repair single ventricle","description":"Repair of single ventricle with aortic outflow obstruction and aortic arch hypoplasia (hypoplastic left heart syndrome) (eg, norwood procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95874","name":"Guide nerv destr needle emg","description":"Needle electromyography for guidance in conjunction with chemodenervation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54640","name":"Orchiopexy ingun/scrot appr","description":"Orchiopexy, inguinal or scrotal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27695","name":"Repair of ankle ligament","description":"Repair, primary, disrupted ligament, ankle; collateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00918","name":"Anes trurl px urtrl cal rmvl","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2065","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47554","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with removal of calculus/calculi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33927","name":"Impltj tot rplcmt hrt sys","description":"Implantation of a total replacement heart system (artificial heart) with recipient cardiectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20933","name":"Hemicrt intrclry algrft prtl","description":"Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11982","name":"Remove drug implant device","description":"Removal, non-biodegradable drug delivery implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87536","name":"Hiv-1 quant&revrse trnscrpj","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, quantification, includes reverse transcription when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24505","name":"Cltx humrl shft fx w/mnpj","description":"Closed treatment of humeral shaft fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93313","name":"Echo transesophageal","description":"Echocardiography, transesophageal, real-time with image documentation (2d) (with or without m-mode recording); placement of transesophageal probe only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28446","name":"Opn osteochondrl agrft talus","description":"Open osteochondral autograft, talus (includes obtaining graft[s])","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96155","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"Prev visit est age 40-64","description":"Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99605","name":"Mtms by pharm np 15 min","description":"Medication therapy management service(s) provided by a pharmacist, individual, face-to-face with patient, with assessment and intervention if provided; initial 15 minutes, new patient","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90838","name":"Psytx w pt w e/m 60 min","description":"Psychotherapy, 60 minutes with patient when performed with an evaluation and management service (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99355","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33140","name":"Heart revascularize (tmr)","description":"Transmyocardial laser revascularization, by thoracotomy; (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49407","name":"Image cath fluid trns/vgnl","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst); peritoneal or retroperitoneal, transvaginal or transrectal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89050","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01470","name":"Anes px nrv msc lw l/a/f nos","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73522","name":"X-ray exam hips bi 3-4 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 3-4 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01830","name":"Anes arthr/ndsc wrst/hnd nos","description":"Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49557","name":"Rerepair fem hernia blocked","description":"Repair recurrent femoral hernia; incarcerated or strangulated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25170","name":"Resect radius/ulnar tumor","description":"Radical resection of tumor, radius or ulna","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01442","name":"Anes px art knee&pop teaec","description":"Anesthesia for procedures on arteries of knee and popliteal area; popliteal thromboendarterectomy, with or without patch graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93261","name":"Interrogate subq defib","description":"Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable subcutaneous lead defibrillator system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11626","name":"Exc s/n/h/f/g mal+mrg >4 cm","description":"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77523","name":"Proton trmt intermediate","description":"Proton treatment delivery; intermediate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77003","name":"Fluoroguide for spine inject","description":"Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural or subarachnoid) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84087","name":"Assay phosphohexose enzymes","description":"Phosphohexose isomerase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44377","name":"Small bowel endoscopy/biopsy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97130","name":"Ther ivntj ea addl 15 min","description":"Therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving, and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing, and sequencin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22319","name":"Treat odontoid fx w/graft","description":"Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87899","name":"Agent nos assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0112","name":"Potassium hydroxide preps","description":"All potassium hydroxide (koh) preparations","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0423","name":"Intens cardiac rehab no exer","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2311","name":"Electro connect btw 2 sys","description":"Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00834","name":"Anes hernia repair<1 yr age","description":"Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31588","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19081","name":"Bx breast 1st lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28465","name":"Optx tarsal bone fx each","description":"Open treatment of tarsal bone fracture (except talus and calcaneus), includes internal fixation, when performed, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23616","name":"Optx prx hmrl fx fix rpr rpl","description":"Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed; with proximal humeral prosthetic replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36011","name":"Place catheter in vein","description":"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64408","name":"Njx aa&/strd vagus nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; vagus nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01636","name":"Anes open/arthr ntrthrc amp","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; interthoracoscapular (forequarter) amputation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64612","name":"Destroy nerve face muscle","description":"Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4528","name":"Adult size pull-on xl","description":"Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92133","name":"Cptrzd oph dx img pst sgm on","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), posterior segment, with interpretation and report, unilateral or bilateral; optic nerve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50820","name":"Construct bowel bladder","description":"Ureteroileal conduit (ileal bladder), including intestine anastomosis (bricker operation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00626","name":"Anes thrc spine w/1 lng vent","description":"Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29889","name":"Arthrs aid pcl rpr/agmntj","description":"Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76802","name":"Ob us < 14 wks addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27828","name":"Treat lower leg fracture","description":"Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both tibia and fibula","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27696","name":"Repair of ankle ligaments","description":"Repair, primary, disrupted ligament, ankle; both collateral ligaments","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35372","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53854","name":"Trurl dstrj prst8 tiss rf wv","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6412","name":"Occlusive eye patch","description":"Eye patch, occlusive, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49566","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67917","name":"Repair eyelid defect","description":"Repair of ectropion; extensive (eg, tarsal strip operations)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3102.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25628","name":"Optx carpl scphd fx int fixj","description":"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86343","name":"Leukocyte histamine release","description":"Leukocyte histamine release test (lhr)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87562","name":"M.avium-intra dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33858","name":"As-aort grf f/aortic dsj","description":"Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, when performed; for aortic dissection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50686","name":"Measure ureter pressure","description":"Manometric studies through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97162","name":"Pt eval mod complex 30 min","description":"Physical therapy evaluation: moderate complexity, requiring these components: a history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; an examination of body systems using standardized tests and measures in addressing a total of 3 or more elements fro","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54328","name":"Revise penis/urethra","description":"1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34705","name":"Evac rpr a-biiliac ndgft","description":"Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72149","name":"Mri lumbar spine w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99150","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20561","name":"Ndl insj w/o njx 3+ musc","description":"Needle insertion(s) without injection(s); 3 or more muscles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97607","name":"Neg prs wnd thr ndme<=50sqcm","description":"Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ongoing care, per session; total wound(s) surfac","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53447","name":"Remove/replace ur sphincter","description":"Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00546","name":"Anes thrcm px pulm rescj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45317","name":"Proctosigmoidoscopy bleed","description":"Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21255","name":"Reconstruct lower jaw bone","description":"Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53445","name":"Insert uro/ves nck sphincter","description":"Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0276","name":"Pild/placebo control clin tr","description":"Blinded procedure for lumbar stenosis, percutaneous image-guided lumbar decompression (pild) or placebo-control, performed in an approved coverage with evidence development (ced) clinical trial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27156","name":"Revision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and with open reduction of hip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50548","name":"Laparo remove w/ureter","description":"Laparoscopy, surgical; nephrectomy with total ureterectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30140","name":"Resect inferior turbinate","description":"Submucous resection inferior turbinate, partial or complete, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62287","name":"Dcmprn pq nuc pul 1/mlt lmbr","description":"Decompression, percutaneous, of nucleus pulposus of intervertebral disc, any method utilizing needle-based technique to remove disc material under fluoroscopic imaging or other form of indirect visualization, with discography and/or epidural injection(s) at the treated level(s), when performed, sing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71555","name":"Mri angio chest w or w/o dye","description":"Magnetic resonance angiography, chest (excluding myocardium), with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10030","name":"Img gid flu coll drg sft tis","description":"Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78464","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86617","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunoblot)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65785","name":"Impltj ntrstrml crnl rng seg","description":"Implantation of intrastromal corneal ring segments","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37722","name":"Lig div&strpg long saph vein","description":"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22015","name":"I&d abscess p-spine l/s/ls","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80055","name":"Obstetric panel","description":"Obstetric panel this panel must include the following: blood count, complete (cbc), automated and automated differential wbc count (85025 or 85027 and 85004) or blood count, complete (cbc), automated (85027) and appropriate manual differential wbc count (85007 or 85009) hepatitis b surface antigen (","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93527","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12031","name":"Intmd rpr s/a/t/ext 2.5 cm/<","description":"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57558","name":"D&c of cervical stump","description":"Dilation and curettage of cervical stump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99236","name":"Hosp ip/obs same date hi 85","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter f","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27065","name":"Remove hip bone les super","description":"Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater trochanter of femur; superficial, includes autograft, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33949","name":"Ecmo/ecls daily mgmt artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; daily management, each day, veno-arterial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11102","name":"Tangntl bx skin single les","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21013","name":"Exc face tum deep < 2 cm","description":"Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78491","name":"Myocrd img pet 1std rst/strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93640","name":"Ep eval 1/2chmbr pacg cvdfb","description":"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time of initial implantation or replacement;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28102","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38382","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; abdominal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46612","name":"Anoscopy remove lesions","description":"Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1092","name":"Wheelchair wide w/ leg rests","description":"Wide heavy duty wheel chair, detachable arms (desk or full length), swing away detachable elevating leg rests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65781","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36440","name":"Bld push tfuj 2 yr/<","description":"Push transfusion, blood, 2 years or younger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90880","name":"Hypnotherapy","description":"Hypnotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"Office o/p new low 30 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. when using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26546","name":"Repair nonunion hand","description":"Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or without external or internal fixation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24363","name":"Replace elbow joint","description":"Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64766","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-06","zip":"10985","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81413","name":"Car ion chnnlpath inc 10 gns","description":"Cardiac ion channelopathies (eg, brugada syndrome, long qt syndrome, short qt syndrome, catecholaminergic polymorphic ventricular tachycardia); genomic sequence analysis panel, must include sequencing of at least 10 genes, including ank2, casq2, cav3, kcne1, kcne2, kcnh2, kcnj2, kcnq1, ryr2, and scn","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","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":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43810","name":"Gastroduodenostomy","description":"Gastroduodenostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01320","name":"Anes all px nrv msc kne&/pop","description":"Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37208","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15789","name":"Chemical peel facial dermal","description":"Chemical peel, facial; dermal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82307","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35231","name":"Repair blvsl vn grf neck","description":"Repair blood vessel with vein graft; neck","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["QW","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89132","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61760","name":"Implant brain electrodes","description":"Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0563T","name":"Evac meibomian glnd heat bi","description":"Evacuation of meibomian glands, using heat delivered through wearable, open-eye eyelid treatment devices and manual gland expression, bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46260","name":"Remove in/ex hem groups 2+","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72197","name":"Mri pelvis w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93306","name":"Tte w/doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95926","name":"Somatosensory testing","description":"Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in lower limbs","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43284","name":"Laps esophgl sphnctr agmntj","description":"Laparoscopy, surgical, esophageal sphincter augmentation procedure, placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33370","name":"Tcat plmt&rmvl cepd perq","description":"Transcatheter placement and subsequent removal of cerebral embolic protection device(s), including arterial access, catheterization, imaging, and radiological supervision and interpretation, percutaneous (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96168","name":"Hlth bhv ivntj fam ea addl","description":"Health behavior intervention, family (with the patient present), face-to-face; each additional 15 minutes (list separately in addition to code for primary service)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93321","name":"Doppler echo f-up/lmtd std","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); follow-up or limited study (list separately in addition to codes for echocardiographic imaging)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2252","name":"Brief chkin by md/qhp, 11-20","description":"Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor le","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28160","name":"Partial removal of toe","description":"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98961","name":"Edu&trn pt slf-mgmt nqhp 2-4","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; 2-4 patients","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25530","name":"Cltx ulnar shft fx w/o mnpj","description":"Closed treatment of ulnar shaft fracture; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47700","name":"Exploration of bile ducts","description":"Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or without cholangiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27871","name":"Fusion of tibiofibular joint","description":"Arthrodesis, tibiofibular joint, proximal or distal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58263","name":"Vag hyst w/t/o & vag repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93298","name":"Rem interrog dev eval scrms","description":"Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22551","name":"Arthrd ant ntrbdy cervical","description":"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below c2","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99378","name":"Hospice care supervision","description":"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60000","name":"I&d thyroglssl dux cst infct","description":"Incision and drainage of thyroglossal duct cyst, infected","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93307","name":"Tte w/o doppler complete","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, complete, without spectral or color doppler echocardiography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27695","name":"Repair of ankle ligament","description":"Repair, primary, disrupted ligament, ankle; collateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4570","name":"Splint","description":"Splint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71040","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47540","name":"Perq plmt bile duct stent","description":"Placement of stent(s) into a bile duct, percutaneous, including diagnostic cholangiography, imaging guidance (eg, fluoroscopy and/or ultrasound), balloon dilation, catheter exchange(s) and catheter removal(s) when performed, and all associated radiological supervision and interpretation; new access,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66761","name":"Revision of iris","description":"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"55801","name":"Removal of prostate","description":"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87428","name":"Sarscov & inf vir a&b ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, sars-cov, s","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1806","name":"Sps wrist device","description":"Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0339","name":"Robot lin-radsurg com, first","description":"Image-guided robotic linear accelerator-based stereotactic radiosurgery, complete course of therapy in one session or first session of fractionated treatment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0405","name":"Ekg interpret & report preve","description":"Electrocardiogram, routine ecg with 12 leads; interpretation and report only, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40019.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67255","name":"Reinforce/graft eye wall","description":"Scleral reinforcement (separate procedure); with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21181","name":"Rcnst cntrg b9 tum crnl xtrc","description":"Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8680","name":"Implt neurostim elctr each","description":"Implantable neurostimulator electrode, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27181","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; osteotomy and internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78454","name":"Ht musc image planar mult","description":"Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86485","name":"Skin test candida","description":"Skin test; candida","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29891","name":"Arthr ank ostchn df tal&/tib","description":"Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defect","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43755","name":"Dx gastr intub w/asp specs","description":"Gastric intubation and aspiration, diagnostic; collection of multiple fractional specimens with gastric stimulation, single or double lumen tube (gastric secretory study) (eg, histamine, insulin, pentagastrin, calcium, secretin), includes drug administration","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25115","name":"Remove wrist/forearm lesion","description":"Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, tbc, or other granulomas, rheumatoid arthritis); flexors","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0559T","name":"Antmc mdl 3d print 1st cmpnt","description":"Anatomic model 3d-printed from image data set(s); first individually prepared and processed component of an anatomic structure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36416","name":"Collj capillary blood spec","description":"Collection of capillary blood specimen (eg, finger, heel, ear stick)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"Prev med cnsl indiv apprx 15","description":"Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53850","name":"Prostatic microwave thermotx","description":"Transurethral destruction of prostate tissue; by microwave thermotherapy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4215","name":"Sterile needle","description":"Needle, sterile, any size, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95808","name":"Polysom any age 1-3> param","description":"Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01710","name":"Anes px nrv musc upr a&e nos","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77307","name":"Telethx isodose plan cplx","description":"Teletherapy isodose plan; complex (multiple treatment areas, tangential ports, the use of wedges, blocking, rotational beam, or special beam considerations), includes basic dosimetry calculation(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87633","name":"Resp virus 12-25 targets","description":"Infectious agent detection by nucleic acid (dna or rna); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique,","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95801","name":"Slp stdy unatnd w/anal","description":"Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial tone)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2992.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87498","name":"Enterovirus probe&revrs trns","description":"Infectious agent detection by nucleic acid (dna or rna); enterovirus, amplified probe technique, includes reverse transcription when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92973","name":"Prq trluml c mchn asp thrmbc","description":"Percutaneous transluminal coronary mechanical aspiration thrombectomy (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83874","name":"Assay of myoglobin","description":"Myoglobin","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33647","name":"Repair heart septum defects","description":"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54162","name":"Lysis penil circumic lesion","description":"Lysis or excision of penile post-circumcision adhesions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35533","name":"Art byp grft axill/fem/fem","description":"Bypass graft, with vein; axillary-femoral-femoral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47015","name":"Lapt aspir&/njx hep prst cst","description":"Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) cyst(s) or abscess(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61315","name":"Crnec/crnot ittl ntracereblr","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43113","name":"Removal of esophagus","description":"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01992","name":"Anes dx/ther nrv blk&inj prn","description":"Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46261","name":"Remove in/ex hem grps & fiss","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01656","name":"Anes art sho&ax ax-fem bpg","description":"Anesthesia for procedures on arteries of shoulder and axilla; axillary-femoral bypass graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74251","name":"X-ray xm sm int 2cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; double-contrast (eg, high-density barium and air via enteroclysis tube) study, including glucagon, when administered","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30520","name":"Repair of nasal septum","description":"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95807","name":"Sleep study attended","description":"Sleep study, simultaneous recording of ventilation, respiratory effort, ecg or heart rate, and oxygen saturation, attended by a technologist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88263","name":"Chromosome analysis 45","description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21435","name":"Optx crnfc sep comp int&/xtr","description":"Open treatment of craniofacial separation (lefort iii type); complicated, utilizing internal and/or external fixation techniques (eg, head cap, halo device, and/or intermaxillary fixation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66682","name":"Repair iris & ciliary body","description":"Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (eg, mccannel suture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33011","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2310","name":"Electro connect btw control","description":"Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5339.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1818","name":"Sps/pass forearm device","description":"Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22310","name":"Closed tx vert fx w/o manj","description":"Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92537","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; bithermal (ie, one warm and one cool irrigation in each ear for a total of four irrigations)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00926","name":"Anes male gent rad orch ing","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27120","name":"Reconstruction of hip socket","description":"Acetabuloplasty; (eg, whitman, colonna, haygroves, or cup type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28570","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; without anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00930","name":"Anes px male gent orchiopexy","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27438","name":"Revise kneecap with implant","description":"Arthroplasty, patella; with prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19355","name":"Correct inverted nipple(s)","description":"Correction of inverted nipples","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67043","name":"Vit for membrane dissect","description":"Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and laser photocoagulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31595","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21932","name":"Exc back tum deep < 5 cm","description":"Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43256","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33647","name":"Repair heart septum defects","description":"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50434","name":"Convert nephrostomy catheter","description":"Convert nephrostomy catheter to nephroureteral catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, via pre-existing nephrostomy tract","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47712","name":"Excision of bile duct tumor","description":"Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28636","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37722","name":"Lig div&strpg long saph vein","description":"Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0878","name":"Pwc gp4 std sing pow opt cap","description":"Power wheelchair, group 4 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83662","name":"Foam stability fetal lung","description":"Fetal lung maturity assessment; foam stability test","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15120","name":"Splt agrft f/s/n/h/f/g/m 1st","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21088","name":"Impres&prep facial prosth","description":"Impression and custom preparation; facial prosthesis","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0505T","name":"Ev fempop artl revsc","description":"Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapp","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95805","name":"Multiple sleep latency test","description":"Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation of physiological measurements of sleep during multiple trials to assess sleepiness","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81171","name":"Aff2 gen aly detc abnl allel","description":"Aff2 (alf transcription elongation factor 2 [fmr2]) (eg, fragile x intellectual disability 2 [fraxe]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93297","name":"Rem interrog dev eval icpms","description":"Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors, analysis, review(s) and report(s) by a physician or other quali","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15335","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92082","name":"Intermediate visual field xm","description":"Visual field examination, unilateral or bilateral, with interpretation and report; intermediate examination (eg, at least 2 isopters on goldmann perimeter, or semiquantitative, automated suprathreshold screening program, humphrey suprathreshold automatic diagnostic test, octopus program 33)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99484","name":"Care mgmt svc bhvl hlth cond","description":"Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month, with the following required elements: initial assessment or follow-up monitoring, including the use of appli","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"48145","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81000","name":"Urinalysis nonauto w/scope","description":"Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, ph, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78452","name":"Ht muscle image spect mult","description":"Myocardial perfusion imaging, tomographic (spect) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); multiple studies, at rest and/or stress (exercise or pharmacologic) and/or red","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0069","name":"Rr whl compl sol tire rep ea","description":"Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43256","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45910","name":"Dilation of rectal narrowing","description":"Dilation of rectal stricture (separate procedure) under anesthesia other than local","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23800","name":"Arthrodesis glenohumeral jt","description":"Arthrodesis, glenohumeral joint;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23406","name":"Incise tendon(s) & muscle(s)","description":"Tenotomy, shoulder area; multiple tendons through same incision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44136","name":"Intestine transplant live","description":"Intestinal allotransplantation; from living donor","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95251","name":"Cont gluc mntr analysis i&r","description":"Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for a minimum of 72 hours; analysis, interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0641","name":"Multi-position stnd fram sys","description":"Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83045","name":"Hgb methemoglobin qual","description":"Hemoglobin; methemoglobin, qualitative","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3060.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86490","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0297T","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00860","name":"Anes xtrprtl px lwr abd nos","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97003","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14418.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88334","name":"Path consltj surg cyto xm ea","description":"Pathology consultation during surgery; cytologic examination (eg, touch prep, squash prep), each additional site (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00948","name":"Anes vag px crv cerclage","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4298.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47552","name":"Biliary endo perq dx w/speci","description":"Biliary endoscopy, percutaneous via t-tube or other tract; diagnostic, with collection of specimen(s) by brushing and/or washing, when performed (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56630","name":"Vulvectomy radical partial","description":"Vulvectomy, radical, partial;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33788","name":"Revision of pulmonary artery","description":"Reimplantation of an anomalous pulmonary artery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74712","name":"Mri fetal sngl/1st gestation","description":"Magnetic resonance (eg, proton) imaging, fetal, including placental and maternal pelvic imaging when performed; single or first gestation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23120","name":"Claviculectomy partial","description":"Claviculectomy; partial","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4203.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26490","name":"Revise thumb tendon","description":"Opponensplasty; superficialis tendon transfer type, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38530","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, internal mammary node(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89140","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S4989","name":"Contracept iud","description":"Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77404","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47570","name":"Laparo cholecystoenterostomy","description":"Laparoscopy, surgical; cholecystoenterostomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44180","name":"Lap enterolysis","description":"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88162","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; extended study involving over 5 slides and/or multiple stains","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32855","name":"Prepare donor lung single","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; unilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2007","name":"Post-d/c h vst ext pt 30 m","description":"Limited (30 minutes) in-home visit for an existing patient post-discharge. for use only in a medicare-approved cmmi model. (services must be furnished within a beneficiarys home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient faci","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78803","name":"Rp loclzj tum spect 1 area","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect), single area (eg, head, neck, chest, pelvis) or acquisition, single day imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92226","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73721","name":"Mri jnt of lwr extre w/o dye","description":"Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2039.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82286","name":"Assay of bradykinin","description":"Bradykinin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0404","name":"Ekg tracing for initial prev","description":"Electrocardiogram, routine ecg with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66825","name":"Reposition intraocular lens","description":"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0247","name":"Routine footcare pt w lops","description":"Routine foot care by a physician of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) to include, the local care of superficial wounds (i.e. superficial to muscle and fascia) and at least the following if present: (1) local care of superficial wou","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3253","name":"Shoe molded plastazote cust","description":"Foot, molded shoe plastazote (or similar) custom fitted, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01936","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0459","name":"Telehealth inpt pharm mgmt","description":"Inpatient telehealth pharmacologic management, including prescription, use, and review of medication with no more than minimal medical psychotherapy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43270","name":"Egd lesion ablation","description":"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97597","name":"Dbrdmt opn wnd 1st 20 cm/<","description":"Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound assessment, use of a whirlpool, when perform","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7168.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"Motor &/ sens nrve cndj test","description":"Motor and/or sensory nerve conduction, using preconfigured electrode array(s), amplitude and latency/velocity study, each limb, includes f-wave study when performed, with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0011","name":"Stnd wt pwr whlchr w control","description":"Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36589","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous catheter, without subcutaneous port or pump","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63045","name":"Lam facetec & foramot crv","description":"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92352","name":"Fit aphakia spectcl monofocl","description":"Fitting of spectacle prosthesis for aphakia; monofocal","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61600","name":"Resect/excise cranial lesion","description":"Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L6639","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24530","name":"Cltx sprcndylr humeral fx wo","description":"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20665","name":"Rmvl tongs/halo anthr indiv","description":"Removal of tongs or halo applied by another individual","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67875","name":"Closure of eyelid by suture","description":"Temporary closure of eyelids by suture (eg, frost suture)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15933","name":"Exc sac pr ulc prim str ostc","description":"Excision, sacral pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15944","name":"Exc isch pr ulc skn flp clsr","description":"Excision, ischial pressure ulcer, with skin flap closure;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90826","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75665","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61751","name":"Brain biopsy w/ct/mr guide","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance guidance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01760","name":"Anes opn/arthr elb tot rplct","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73225","name":"Mr angio upr extr w/o&w/dye","description":"Magnetic resonance angiography, upper extremity, with or without contrast material(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21930","name":"Exc back les sc < 3 cm","description":"Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45334","name":"Sigmoidoscopy for bleeding","description":"Sigmoidoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0210U","name":"Syphilis tst antb ia quan 5","description":"Syphilis tst antb ia quan 5","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43113","name":"Removal of esophagus","description":"Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine reconstruction, including intestine mobilization, preparation, and anastomosis(es)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75893","name":"Venous sampling by catheter","description":"Venous sampling through catheter, with or without angiography (eg, for parathyroid hormone, renin), radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80051","name":"Electrolyte panel","description":"Electrolyte panel this panel must include the following: carbon dioxide (bicarbonate) (82374) chloride (82435) potassium (84132) sodium (84295)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75635","name":"Ct angio abdominal arteries","description":"Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4772","name":"Blood glucose test strips","description":"Blood glucose test strips, for dialysis, per 50","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34713","name":"Perq access & clsr fem art","description":"Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 french or larger), including ultrasound guidance, when performed, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78014","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed); with single or multiple uptake(s) quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99378","name":"Hospice care supervision","description":"Supervision of a hospice patient (patient not present) requiring complex and multidisciplinary care modalities involving regular development and/or revision of care plans by that individual, review of subsequent reports of patient status, review of related laboratory and other studies, communication","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47510","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"Review patient spirometry","description":"Patient-initiated spirometric recording per 30-day period of time; review and interpretation only by a physician or other qualified health care professional","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15838","name":"Exc excsv submental fat pad","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45327","name":"Proctosigmoidoscopy w/stent","description":"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-06-06","locality":"1320201","zip":"10001","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"22862","name":"Rev rplcm rthrp 1ntrspc lmbr","description":"Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52354","name":"Cystouretero w/biopsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64454","name":"Njx aa&/strd gnclr nrv brnch","description":"Injection(s), anesthetic agent(s) and/or steroid; genicular nerve branches, including imaging guidance, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33871","name":"Transvrs a-arch grf hypthrm","description":"Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia, total circulatory arrest and isolated cerebral perfusion with reimplantation of arch vessel(s) (eg, island pedicle or individual arch vessel reimplantation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87274","name":"Herpes simplex 1 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 1","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50435","name":"Exchange nephrostomy cath","description":"Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0123","name":"Screen cerv/vag thin layer","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58292","name":"Vag hyst t/o & repair compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84270","name":"Assay of sex hormone globul","description":"Sex hormone binding globulin (shbg)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82106","name":"Alpha-fetoprotein amniotic","description":"Alpha-fetoprotein (afp); amniotic fluid","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72194","name":"Ct pelvis w/o & w/dye","description":"Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4126.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24546","name":"Optx hum fx w/ntrcndylr xtn","description":"Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondylar extension","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22900","name":"Exc abdl tum deep < 5 cm","description":"Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29871","name":"Arthrs knee surg for infctj","description":"Arthroscopy, knee, surgical; for infection, lavage and drainage","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26357","name":"Repair finger/hand tendon","description":"Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no mans land); secondary, without free graft, each tendon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72141","name":"Mri neck spine w/o dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; without contrast material","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35702","name":"Expl n/flwd surg uxtr art","description":"Exploration not followed by surgical repair, artery; upper extremity (eg, axillary, brachial, radial, ulnar)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49412","name":"Ins device for rt guide open","description":"Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if performed, single or multiple (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11646","name":"Exc f/e/e/n/l mal+mrg >4 cm","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47511","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53860","name":"Transurethral rf treatment","description":"Transurethral radiofrequency micro-remodeling of the female bladder neck and proximal urethra for stress urinary incontinence","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4510","name":"Full length surg stocking","description":"Surgical stockings full length, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98943","name":"Chiropract manj xtrspinl 1/>","description":"Chiropractic manipulative treatment (cmt); extraspinal, 1 or more regions","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23900","name":"Interthoracoscplr amputation","description":"Interthoracoscapular amputation (forequarter)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93285","name":"Prgrmg dev eval scrms ip","description":"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; subcutaneous cardiac rhythm mon","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3221","name":"Orthopedic mens shoes dpth i","description":"Orthopedic footwear, mens shoe, depth inlay, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69601","name":"Revj mstdc rsltg compl mstdc","description":"Revision mastoidectomy; resulting in complete mastoidectomy","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"40720","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93308","name":"Tte f-up or lmtd","description":"Echocardiography, transthoracic, real-time with image documentation (2d), includes m-mode recording, when performed, follow-up or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80406","name":"Acth stimulation panel","description":"Acth stimulation panel; for 3 beta-hydroxydehydrogenase deficiency this panel must include the following: cortisol (82533 x 2) 17 hydroxypregnenolone (84143 x 2)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46706","name":"Repr of anal fistula w/glue","description":"Repair of anal fistula with fibrin glue","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35092","name":"Repair artery rupture aorta","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving visceral vessels (mesenteric, celiac, renal)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11640","name":"Exc f/e/e/n/l mal+mrg 0.5cm<","description":"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5394.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63057","name":"Decompress spine cord add-on","description":"Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01935","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":944.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73725","name":"Mr ang lwr ext w or w/o dye","description":"Magnetic resonance angiography, lower extremity, with or without contrast material(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81189","name":"Cstb gene full gene sequence","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; full gene sequence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23605","name":"Cltx prx hmrl fx mnpj+-tract","description":"Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without skeletal traction","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81286","name":"Fxn gene full gene sequence","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; full gene sequence","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87527","name":"Hepatitis g dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, quantification","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37616","name":"Ligation major artery chest","description":"Ligation, major artery (eg, post-traumatic, rupture); chest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0424","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11600","name":"Exc tr-ext mal+marg 0.5 cm/<","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70557","name":"Mri brain w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull base), during open intracranial procedure (eg, to assess for residual tumor or residual vascular malformation); without contrast material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26850","name":"Fusion of knuckle","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27327","name":"Exc thigh/knee les sc < 3 cm","description":"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01482","name":"Anes opn lwr l/a/f rad rescj","description":"Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27036","name":"Capsulectomy/capsulotomy hip","description":"Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75564","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0112","name":"Potassium hydroxide preps","description":"All potassium hydroxide (koh) preparations","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67445","name":"Explr/decompress eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of bone for decompression","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33265","name":"Ablate atria lmtd endo","description":"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2763.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69511","name":"Extensive mastoid surgery","description":"Mastoidectomy; radical","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3211","name":"Surgical boot each junior","description":"Surgical boot, each, junior","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"56634","name":"Vlvctmy rad comp uni lymphad","description":"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50953","name":"Endoscopy of ureter","description":"Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6007","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3091.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24155","name":"Resection of elbow joint","description":"Resection of elbow joint (arthrectomy)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0615","name":"Pacemaker monitr digital/vis","description":"Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43216","name":"Esophagoscopy lesion removal","description":"Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21355","name":"Perq tx malar fracture","description":"Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65920","name":"Remove implant of eye","description":"Removal of implanted material, anterior segment of eye","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20150","name":"Excision epiphyseal bar","description":"Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained through same fascial incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63195","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4045.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93318","name":"Echo transesophageal intraop","description":"Echocardiography, transesophageal (tee) for monitoring purposes, including probe placement, real time 2-dimensional image acquisition and interpretation leading to ongoing (continuous) assessment of (dynamically changing) cardiac pumping function and to therapeutic measures on an immediate time basi","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0290","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44364","name":"Small bowel endoscopy","description":"Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72082","name":"X-ray exam entire spi 2/3 vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12007","name":"Rpr s/n/ax/gen/trnk >30.0 cm","description":"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0442T","name":"Abltj perc plex/trncl nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99191","name":"Special pump services","description":"Assembly and operation of pump with oxygenator or heat exchanger (with or without ecg and/or pressure monitoring); 45 minutes","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93609","name":"Intra-vntr mapg tchycar site","description":"Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter manipulation to record from multiple sites to identify origin of tachycardia (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["KM","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32551","name":"Insertion of chest tube","description":"Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33010","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"45190","name":"Destruction rectal tumor","description":"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20970","name":"Bone/skin graft iliac crest","description":"Free osteocutaneous flap with microvascular anastomosis; iliac crest","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91035","name":"G-esoph reflx tst w/electrod","description":"Esophagus, gastroesophageal reflux test; with mucosal attached telemetry ph electrode placement, recording, analysis and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33265","name":"Ablate atria lmtd endo","description":"Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary bypass","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67560","name":"Revise eye socket implant","description":"Orbital implant (implant outside muscle cone); removal or revision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-06","locality":"1328299","zip":"12007","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28290","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87143","name":"Culture typing glc/hplc","description":"Culture, typing; gas liquid chromatography (glc) or high pressure liquid chromatography (hplc) method","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15116","name":"Epdrm agrft f/s/n/h/f/g/m ea","description":"Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36861","name":"Cannula declotting","description":"External cannula declotting (separate procedure); with balloon catheter","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78804","name":"Rp loclzj tum whbdy 2+d img","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); planar, whole body, requiring 2 or more days imaging","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4098","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5225.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1553.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33367","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49560","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01430","name":"Anes px veins knee&pop nos","description":"Anesthesia for procedures on veins of knee and popliteal area; not otherwise specified","date_of_service":"2026-06-06","locality":"1320203","zip":"10512","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97036","name":"App mdlty 1+hubbrd tnk ea 15","description":"Application of a modality to 1 or more areas; hubbard tank, each 15 minutes","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11740","name":"Evacuation subungual hmtma","description":"Evacuation of subungual hematoma","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83908","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50572","name":"Kidney endoscopy","description":"Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47544","name":"Removal duct glbldr calculi","description":"Removal of calculi/debris from biliary duct(s) and/or gallbladder, percutaneous, including destruction of calculi by any method (eg, mechanical, electrohydraulic, lithotripsy) when performed, imaging guidance (eg, fluoroscopy), and all associated radiological supervision and interpretation (list sep","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22208","name":"Incis spine 3 column adl seg","description":"Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26676","name":"Pin hand dislocation","description":"Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01758","name":"Anes opn/arthrs elbw exc cst","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; excision of cyst or tumor of humerus","date_of_service":"2026-06-06","locality":"1329204","zip":"11004","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90829","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3208.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26863","name":"Fuse/graft added joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft), each additional joint (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1097.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76513","name":"Oph us dx ant sgm us uni/bi","description":"Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion (water bath) b-scan or high resolution biomicroscopy, unilateral or bilateral","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93624","name":"Ep f-up study pacg&rec","description":"Electrophysiologic follow-up study with pacing and recording to test effectiveness of therapy, including induction or attempted induction of arrhythmia","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31276","name":"Nsl/sins ndsc frnt tiss rmvl","description":"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95930","name":"Visual ep test cns w/i&r","description":"Visual evoked potential (vep) checkerboard or flash testing, central nervous system except glaucoma, with interpretation and report","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76942","name":"Echo guide for biopsy","description":"Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33365","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92933","name":"Prq trlml c athrc st angiop1","description":"Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed, single major coronary artery and/or its branch(es)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23462","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with coracoid process transfer","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93320","name":"Doppler echo complete","description":"Doppler echocardiography, pulsed wave and/or continuous wave with spectral display (list separately in addition to codes for echocardiographic imaging); complete","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95712","name":"Veeg 2-12 hr intmt mntr","description":"Electroencephalogram with video (veeg), review of data, technical description by eeg technologist, 2-12 hours; with intermittent monitoring and maintenance","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"13152","name":"Cmplx rpr e/n/e/l 2.6-7.5 cm","description":"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99350","name":"Home/res vst est high mdm 60","description":"Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. when using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11755","name":"Biopsy nail unit","description":"Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7272","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91012","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28103","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77049","name":"Mri breast c-+ w/cad bi","description":"Magnetic resonance imaging, breast, without and with contrast material(s), including computer-aided detection (cad real-time lesion detection, characterization and pharmacokinetic analysis), when performed; bilateral","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11444","name":"Exc face-mm b9+marg 3.1-4 cm","description":"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82163","name":"Assay of angiotensin ii","description":"Angiotensin ii","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88361","name":"Tumor immunohistochem/comput","description":"Morphometric analysis, tumor immunohistochemistry (eg, her-2/neu, estrogen receptor/progesterone receptor), quantitative or semiquantitative, per specimen, each single antibody stain procedure; using computer-assisted technology","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2623.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29530","name":"Strapping of knee","description":"Strapping; knee","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46750","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; adult","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29915","name":"Hip arthro acetabuloplasty","description":"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61343","name":"Crnec sopl crv lam dcmprn","description":"Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, arnold-chiari malformation)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87555","name":"M.tuberculo dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, direct probe technique","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27745","name":"Reinforce tibia","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87427","name":"Shiga-like toxin ag ia","description":"Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [eia], enzyme-linked immunosorbent assay [elisa], fluorescence immunoassay [fia], immunochemiluminometric assay [imca]), qualitative or semiquantitative; shiga-like toxin","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92987","name":"Revision of mitral valve","description":"Percutaneous balloon valvuloplasty; mitral valve","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66821","name":"After cataract laser surgery","description":"Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (eg, yag laser) (1 or more stages)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00404","name":"Anes integ sys rad/modf brst","description":"Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27536","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5544.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99366","name":"Team conf w/pat by hc prof","description":"Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified health care professional","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3017.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01712","name":"Anes px nrv msc upr a&e tnot","description":"Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25270","name":"Repair forearm tendon/muscle","description":"Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86022","name":"Platelet antibodies","description":"Antibody identification; platelet antibodies","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65800","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64891","name":"Nrv grf 1strnd hnd/foot >4cm","description":"Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5960.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-06-06","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":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"43400","name":"Ligate esophagus veins","description":"Ligation, direct, esophageal varices","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1277.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17108","name":"Dstr cut vsc prlf les>50sqcm","description":"Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35216","name":"Rpr blvsl dir ntrthrc wo byp","description":"Repair blood vessel, direct; intrathoracic, without bypass","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","KE","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":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93452","name":"Left hrt cath w/ventrclgrphy","description":"Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["26","95","ET"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15240","name":"Fth/gft f/c/c/m/n/ax/g/h/f20","description":"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36500","name":"Insertion of catheter vein","description":"Venous catheterization for selective organ blood sampling","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31633","name":"Bronchoscopy/needle bx addl","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26675","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36566","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63078","name":"Spine disk surgery thorax","description":"Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (list separately in addition to code for primary procedure)","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31084","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-06-06","zip":"10985","rural":"Y","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33961","name":"UNK","description":"UNK","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73220","name":"Mri uppr extremity w/o&w/dye","description":"Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by contrast material(s) and further sequences","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00942","name":"Anes vag px clptmy vgnc clpr","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","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":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92538","name":"Caloric vstblr test w/rec","description":"Caloric vestibular test with recording, bilateral; monothermal (ie, one irrigation in each ear for a total of two irrigations)","date_of_service":"2026-06-06","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27635","name":"Remove lower leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula;","date_of_service":"2026-06-06","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":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["95","ET","NU"]}],"provider_references":[1]}]}]}
